Healthcare Provider Details

I. General information

NPI: 1619654860
Provider Name (Legal Business Name): RACHEL MUSSA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 LOUETTA RD STE A
HOUSTON TX
77070-1282
US

IV. Provider business mailing address

11620 LOUETTA RD STE A
HOUSTON TX
77070-1282
US

V. Phone/Fax

Practice location:
  • Phone: 281-320-0400
  • Fax:
Mailing address:
  • Phone: 281-320-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39766
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: