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General NPI Number Information
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NPI Number | 1154139491
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Entity Type | Organization
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Legal Business Name | MY STAR ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 23641 KATY FWY STE 200
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City | KATY
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State | TX
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Zip | 77494-7335
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Country | US
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Telephone | 281-884-9775
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Fax |
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Provider Business Mailing Address
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Address Line | 23641 KATY FWY STE 200
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City | KATY
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State | TX
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Zip | 77494-7335
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Country | US
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Telephone | 281-884-9775
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEATHER LUONG
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Credential | DDS, MBA
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Telephone | 281-884-9775
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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 |
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License Number State |
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