Healthcare Provider Details

I. General information

NPI: 1386202927
Provider Name (Legal Business Name): HUAN KAMIO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 WESLEY ST # A
GREENVILLE TX
75402-6320
US

IV. Provider business mailing address

5601 WESLEY ST # A
GREENVILLE TX
75402-6320
US

V. Phone/Fax

Practice location:
  • Phone: 903-686-1892
  • Fax:
Mailing address:
  • Phone: 903-686-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1858774
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39080
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: