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NPI 1043417413

NPI 1043417413 : PAUL W. NEWMAN D.D.S. PA : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1043417413
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAUL W. NEWMAN D.D.S. PA 
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Dates
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    Enumeration Date     |    06/29/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    1011 AUGUSTA DR SUITE 106
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77057-2062
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    Country              |    US
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    Telephone            |    713-977-7854
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    Fax                  |    713-952-7860
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Provider Business Mailing Address
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    Address Line         |    1011 AUGUSTA DR SUITE 106
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77057-2062
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    Country              |    US
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    Telephone            |    713-977-7854
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    Fax                  |    713-952-7860
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |     PAUL WAYNE NEWMAN 
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    Credential           |    D.D.S.
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    Telephone            |    713-977-7854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    16013
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    License Number State |    TX
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