Healthcare Provider Details

I. General information

NPI: 1184751471
Provider Name (Legal Business Name): HAROLD KAISER HEUSZEL D.D.S.,FAGD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11326 WESTHEIMER RD SUITE B
HOUSTON TX
77077-6865
US

IV. Provider business mailing address

1203 HEATHWOOD DR
HOUSTON TX
77077-2617
US

V. Phone/Fax

Practice location:
  • Phone: 281-558-2792
  • Fax: 281-597-0277
Mailing address:
  • Phone: 281-870-5848
  • Fax: 281-920-1737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13889
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: