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NPI Code Detail

MEDICARE: JING GUO BDS, MS, PHD

MEDICARE:   JING  GUO  BDS, MS, PHD
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
11223E0200XEndodontics33519TX

General Provider Information

NPI Number : 1699270199
Entity Type Code : Individual
Provider Name (Legal Business Name) : JING GUO BDS, MS, PHD
Provider Business Mailing Address
First Line : 5020 CYPRESS CREEK PKWY STE B1
Second Line :
City : HOUSTON
State : TX
Zip : 77069-4521
Country : US
Telephone Number : 281-580-9058
Fax Number :
Provider Business Practice Location Address
First Line : 5020 CYPRESS CREEK PKWY STE B1
Second Line :
City : HOUSTON
State : TX
Zip : 77069-4521
Country : US
Telephone Number : 213-509-1701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2018
Last Update Date : 11/25/2019

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Directions to “ JING GUO BDS, MS, PHD” Practice Location

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