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NPI Code Detail

MEDICARE: CENTRA SOHO PLLC

MEDICARE: CENTRA SOHO PLLC
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1760028021
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRA SOHO PLLC
Provider Business Mailing Address
First Line : 701 COLLEGE AVE
Second Line :
City : SOUTH HOUSTON
State : TX
Zip : 77587-4205
Country : US
Telephone Number : 713-941-7555
Fax Number :
Provider Business Practice Location Address
First Line : 701 COLLEGE AVE
Second Line :
City : SOUTH HOUSTON
State : TX
Zip : 77587-4205
Country : US
Telephone Number : 713-941-7555
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KATHY NGUYEN
Credential : DDS
Telephone Number : 832-289-8803
Provider Enumeration Date : 11/21/2019
Last Update Date : 11/21/2019

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Directions to “CENTRA SOHO PLLC ” Practice Location

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