Randolph A Ibarra DDS

NPI 1003878034 - Dentist - 1223G0001X

NPI Details
NPI 1003878034
Gender Male
Enumeration Date 04/05/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
8744 GRISSOM RD
SAN ANTONIO TX, 78251-4819, US
Phone (210) 523-0000
Fax (210) 523-0067
Business Location
8355 CRESTWAY DR
1126
CONVERSE TX, 78109-3596, US
Phone (210) 623-6112
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 14645
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According to our database, Dr. Randolph A Ibarra DDS NPI is 1003878034, taxonomy code is 1223G0001X and license number is 14645, license state is located at Texas. Randolph A Ibarra DDS physically located at 8744 Grissom Rd, San Antonio TX, 78251-4819. NPI Number Randolph A Ibarra DDS has the Individual type.

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1003878034 NPI number is provided on an as is basis without warranty of any kind. 1003878034 is maintained by the National Plan & Provider Enumeration System. The contents of Randolph A Ibarra DDS are for informational purposes only.