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General NPI Number Information
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NPI Number | 1124438668
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Entity Type | Individual
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Provider Name | PHYLICIA COMBEST DDS
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Gender | Female
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 01/01/2020
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Provider Practice Location Address
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Address Line | 900 S WAYSIDE DR STE 100
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City | HOUSTON
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State | TX
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Zip | 77023-3418
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Country | US
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Telephone | 832-203-7968
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Fax |
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Provider Business Mailing Address
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Address Line | 3852 TELEPHONE RD APT 3204
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City | HOUSTON
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State | TX
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Zip | 77023-5754
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Country | US
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Telephone | 228-249-2184
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1001361
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 31638
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License Number State | TX
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