Healthcare Provider Details

I. General information

NPI: 1720995459
Provider Name (Legal Business Name): STA&D PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 VISTA RD STE D
PASADENA TX
77504-2140
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 713-560-5207
  • Fax:
Mailing address:
  • Phone: 713-560-5207
  • Fax:

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: DR. NEDA DODIG
Title or Position: DIRECTOR
Credential: DDS
Phone: 713-560-5207