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General NPI Number Information
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NPI Number | 1184587271
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Entity Type | Individual
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Provider Name | EFREN MESA CARMONA
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 23950 FRANZ RD STE 400
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City | KATY
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State | TX
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Zip | 77493-5728
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Country | US
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Telephone | 832-437-5895
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Fax |
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Provider Business Mailing Address
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Address Line | 6118 LILLYBELLE ST
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City | KATY
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State | TX
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Zip | 77449-2220
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Country | US
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Telephone | 832-519-4104
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 27954
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License Number State | TX
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