Tx Southern Dental PPO PC
Tx Southern Dental PPO PC is a Periodontics in San Antonio, Texas. Registered with an NPI since 2025.
- In the registry since
- 2025
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4871 Fredericksburg RdSan Antonio, TX 78229-3627
Phone: (210) 349-5553
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X |
|---|
Record details
| NPI number | 1063300960 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Tx Southern Dental PPO PC |
| Authorized official | Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137 |
| Other names | Ricardo Diaz Dds |
| NPI enumerated | June 27, 2025 |
| Last updated in NPPES | June 27, 2025 |
| Certification date | June 27, 2025 |
| Mailing address | 5830 Granite Pkwy Ste 780, Plano, TX 75024-6775 |
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