Provider Demographics
NPI:1053432187
Name:JL CAZARES DDS PA
Entity type:Organization
Organization Name:JL CAZARES DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:CAZARES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-686-5000
Mailing Address - Street 1:1632 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4103
Mailing Address - Country:US
Mailing Address - Phone:956-686-5000
Mailing Address - Fax:956-686-6562
Practice Address - Street 1:1632 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4103
Practice Address - Country:US
Practice Address - Phone:956-686-5000
Practice Address - Fax:956-686-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty