MYSA DENTAL PLLC
MYSA DENTAL · Clinic/Center (Dental)

Address: 13762 Potranco Rd Ste 105, San Antonio, TX 78253-4047

MYSA DENTAL PLLC (NPI# 1710587431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710587431
Entity Type Organization
Organization Name MYSA DENTAL PLLC
Other Organization Name MYSA DENTAL (Doing Business As Name)
Practice Address 13762 Potranco Rd Ste 105
San Antonio
TX 78253-4047
Practice Telephone 2105649044
Practice Fax Number 2105649088
Mailing Address 10615 Ysamy Way
San Antonio
TX 78213-1659
Mailing Telephone 6178344646
Certification Date 2021-03-10
Enumeration Date 2020-10-30
Last Update Date 2021-03-10
Authorized Official Telephone 6178344646
Authorized Official Credential DMD
Is Organization Subpart Y
Parent Organization Name MYSA DENTAL PLLC

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Mysa Dental Doing Business As Name

Office Location

Street Address 13762 POTRANCO RD STE 105
City SAN ANTONIO
State TX
Zip Code 78253-4047

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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City SAN ANTONIO
Zip Code 78253

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.