Provider Demographics
NPI:1184146169
Name:MEZA, JOSE NED (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:NED
Last Name:MEZA
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 1:312 PECAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2355
Mailing Address - Country:US
Mailing Address - Phone:956-687-6453
Mailing Address - Fax:956-687-6455
Practice Address - Street 1:312 PECAN BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2355
Practice Address - Country:US
Practice Address - Phone:956-687-6453
Practice Address - Fax:956-687-6455
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice