Healthcare Provider Details

I. General information

NPI: 1114889474
Provider Name (Legal Business Name): SRM SMILESPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14095 NORTHWEST FWY STE D
HOUSTON TX
77040-5133
US

IV. Provider business mailing address

8914 ASHCROFT CREEK CT
CYPRESS TX
77433-5326
US

V. Phone/Fax

Practice location:
  • Phone: 214-713-1364
  • Fax:
Mailing address:
  • Phone: 210-350-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NEHA BANSAL
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 210-350-2200