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General NPI Number Information
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NPI Number | 1134732217
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Entity Type | Individual
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Provider Name | DR. KIRK LYNDELL WARD II
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Gender | Male
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 12661 W LAKE HOUSTON PKWY STE G
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City | HOUSTON
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State | TX
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Zip | 77044-1454
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Country | US
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Telephone | 281-372-0216
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Fax |
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Provider Business Mailing Address
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Address Line | 811 FLANNERS CT
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City | SPRING
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State | TX
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Zip | 77373-8263
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Country | US
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Telephone | 713-397-7971
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36597
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License Number State | TX
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