Healthcare Provider Details

I. General information

NPI: 1619089067
Provider Name (Legal Business Name): SCHWARTZ AND GORDON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 SOUTH MAIN STE 610
HOUSTON TX
77030
US

IV. Provider business mailing address

7515 SOUTH MAIN STE 610
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-795-0208
  • Fax: 713-795-5796
Mailing address:
  • Phone: 713-795-0208
  • Fax: 713-795-5796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12440
License Number StateTX

VIII. Authorized Official

Name: DR. TERENCE M GORDON
Title or Position: OWNER
Credential: DDS
Phone: 713-795-0208