Provider Demographics
NPI:1306254792
Name:XAVERIUS, FRANSISCUS
Entity type:Individual
Prefix:
First Name:FRANSISCUS
Middle Name:
Last Name:XAVERIUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 N MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2123
Mailing Address - Country:US
Mailing Address - Phone:225-210-6571
Mailing Address - Fax:
Practice Address - Street 1:1835 N MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2123
Practice Address - Country:US
Practice Address - Phone:225-210-6571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051359122300000X
LA5925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist