Healthcare Provider Details

I. General information

NPI: 1265142269
Provider Name (Legal Business Name): TLN FAMILY & COSMETIC DENTISTRY AT MEYER PARK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10259 S POST OAK RD
HOUSTON TX
77096-4306
US

IV. Provider business mailing address

14522 S POST OAK RD STE 110A
HOUSTON TX
77045-6001
US

V. Phone/Fax

Practice location:
  • Phone: 713-723-2600
  • Fax: 832-377-4791
Mailing address:
  • Phone: 713-723-2600
  • Fax: 832-377-4791

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: CHASITY MOORE
Title or Position: REGIONAL MANAGER
Credential:
Phone: 713-723-2600