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General NPI Number Information
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NPI Number | 1164092854
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Entity Type | Organization
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Legal Business Name | YAC DENTAL CARE PLLC
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 18775 CLAY RD STE A
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City | HOUSTON
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State | TX
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Zip | 77084-7236
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Country | US
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Telephone | 956-413-9156
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Fax | 281-676-4366
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Provider Business Mailing Address
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Address Line | 4602 WILD BLUEBONNET WAY
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City | HOUSTON
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State | TX
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Zip | 77084-2264
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Country | US
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Telephone | 713-557-1825
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Fax | 281-676-4366
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Authorized Official
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Title or Position | MANAGER
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Name | YOLANDA ALVAREZ
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Credential |
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Telephone | 956-413-9156
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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