MEDICARE: ALEXA DENTAL 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
1	261QD0000X	Dental Clinic/Center	26142	TX

General Provider Information

NPI Number	:	1861988826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXA DENTAL PLLC

Provider Business Mailing Address
First Line	:	5547 MANGROVE CREEK LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3770
Country	:	US
Telephone Number	:	832-715-1063
Fax Number	:

Provider Business Practice Location Address
First Line	:	5858 S GESSNER RD STE 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-2646
Country	:	US
Telephone Number	:	713-777-8743
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AI LE
Credential	:	DDS
Telephone Number	:	832-715-1063

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	07/31/2023

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Directions to “ALEXA DENTAL PLLC ” Practice Location

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