Healthcare Provider Details

I. General information

NPI: 1467213710
Provider Name (Legal Business Name): WELCH DENTAL GROUP CYPRESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19655 WEST RD
CYPRESS TX
77433
US

IV. Provider business mailing address

23515 KINGSLAND BLVD
KATY TX
77494-3962
US

V. Phone/Fax

Practice location:
  • Phone: 281-769-8873
  • Fax: 281-769-8872
Mailing address:
  • Phone: 281-395-2112
  • Fax: 281-395-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BARBARA JUST
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 713-906-8442