Healthcare Provider Details

I. General information

NPI: 1982016069
Provider Name (Legal Business Name): MAX TZE-HAN HUANG D.D.S. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 LONDON BRIDGE STA
HOUSTON TX
77045-4644
US

IV. Provider business mailing address

9425 LONDON BRIDGE STA
HOUSTON TX
77045-4644
US

V. Phone/Fax

Practice location:
  • Phone: 832-515-3387
  • Fax:
Mailing address:
  • Phone: 832-515-3387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number33597
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: