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NPI 1285725721

NPI 1285725721 : TEIL LEW DDS : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1285725721
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    Entity Type          |    Individual 
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    Provider Name        |    TEIL LEW DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/28/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    9540 RICHMOND AVE SUITE B
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77063
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    Country              |    US
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    Telephone            |    713-781-7811
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    Fax                  |    713-781-9544
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Provider Business Mailing Address
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    Address Line         |    9540 RICHMOND AVE SUITE B
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77063
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    Country              |    US
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    Telephone            |    713-781-7811
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    Fax                  |    713-781-9544
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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       |    19209
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    License Number State |    TX
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