Tx Southern Dental Ppo PC

NPI #1194601328 in Buda, Texas

Provider Information

NPI Number
1194601328
Entity Type
Organization
Organization Name
Tx Southern Dental Ppo PC
Subpart
Yes (part of a larger organization)
Parent Organization
TX SOUTHERN DENTAL PPO PC
Primary Specialty
Dentist
Enumeration Date
Aug 13, 2025
Last Updated
Aug 13, 2025

Practice Location

Address
108 S MAIN ST
City
Buda
State
Texas
ZIP Code
78610-3375
Phone
(512) 295-9925

Authorized Official

Name
ERIKA MELISSA MENJIVAR
Title
SR. CREDENTIALING SPECIALIST
Phone
(469) 596-6137

Specialties & Taxonomy Codes

Specialty
Dentist

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