Healthcare Provider Details

I. General information

NPI: 1518990324
Provider Name (Legal Business Name): CONTEMPO CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11970 WILCREST DR STE 104
HOUSTON TX
77031-1923
US

IV. Provider business mailing address

5306 FENWICK WAY CT
SUGAR LAND TX
77479-4220
US

V. Phone/Fax

Practice location:
  • Phone: 281-933-6228
  • Fax:
Mailing address:
  • Phone: 281-980-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20826
License Number StateTX

VIII. Authorized Official

Name: DR. JASMINE PENG
Title or Position: OWNER
Credential: DDS
Phone: 281-933-6228