Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 28589 | TX |
Y | 1223P0700X | Prosthodontist | 28589 | TX |
NPI | 1245576917 |
---|---|
Provider Name | Dr. Ricardo A Neira |
First Address | Hidalgo, TX 78557-2933 |
Second Address | Hidalgo, TX 78557-2933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2012 |
Last Update Date | 11/12/2013 |