Provider Demographics
NPI:1366572901
Name:ARMENDARIZ, ALONSO (DDS)
Entity type:Individual
Prefix:DR
First Name:ALONSO
Middle Name:
Last Name:ARMENDARIZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1451
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-1451
Mailing Address - Country:US
Mailing Address - Phone:956-488-8354
Mailing Address - Fax:956-488-8247
Practice Address - Street 1:1314 E SAN BENITO
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-7858
Practice Address - Country:US
Practice Address - Phone:956-488-8354
Practice Address - Fax:956-488-8247
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice