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General NPI Number Information
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NPI Number | 1265685812
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Entity Type | Organization
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Legal Business Name | PALUK-ECHEVERRIA DENTAL PC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 4400 POST OAK PKWY #1190
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City | HOUSTON
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State | TX
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Zip | 77027-3421
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Country | US
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Telephone | 713-398-2663
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Fax | 713-877-1307
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Provider Business Mailing Address
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Address Line | 1901 POST OAK BLVD #506
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City | HOUSTON
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State | TX
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Zip | 77056-3868
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Country | US
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Telephone | 713-398-2882
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Fax | 713-877-1307
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. SERGIO FABIAN PALUK
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Credential | DDS MS
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Telephone | 713-398-2882
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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 | 21665
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License Number State | TX
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