MEDICARE: DR. LETICIA TURULLOLS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	013042	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639276165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LETICIA TURULLOLS DDS

Provider Business Mailing Address
First Line	:	633 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2423
Country	:	US
Telephone Number	:	713-694-9070
Fax Number	:	713-694-1487

Provider Business Practice Location Address
First Line	:	633 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2423
Country	:	US
Telephone Number	:	713-694-9070
Fax Number	:	713-694-1487

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2006
Last Update Date	:	10/22/2013

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