Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 29546 | TX |
NPI | 1376097287 |
---|---|
Provider Name | Vanessa Vera-Arce |
First Address | San Antonio, TX 78252-2824 |
Second Address | San Antonio, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2016 |
Last Update Date | 09/08/2016 |