Healthcare Provider Details

I. General information

NPI: 1295683712
Provider Name (Legal Business Name): HCD- SPRING BRANCH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21477 STATE HIGHWAY 46 W STE 101
SPRING BRANCH TX
78070-6797
US

IV. Provider business mailing address

21477 STATE HIGHWAY 46 W STE 105
SPRING BRANCH TX
78070-6797
US

V. Phone/Fax

Practice location:
  • Phone: 830-438-2121
  • Fax:
Mailing address:
  • Phone: 830-438-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: CHAD HENDRICKS
Title or Position: CREDENTIALING
Credential:
Phone: 612-859-0444