Healthcare Provider Details

I. General information

NPI: 1982717492
Provider Name (Legal Business Name): JAMES FRANK KRIVAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 GAYLORD ST SUITE 103
HOUSTON TX
77024-2966
US

IV. Provider business mailing address

9090 GAYLORD ST SUITE 103
HOUSTON TX
77024-2966
US

V. Phone/Fax

Practice location:
  • Phone: 713-464-8905
  • Fax: 713-461-7383
Mailing address:
  • Phone: 713-464-8905
  • Fax: 713-461-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number08546
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: