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General NPI Number Information
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NPI Number | 1356881718
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Entity Type | Organization
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Legal Business Name | TEXAS KIDS DENTIST, PLLC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 2780 FM 1463 SUITE 203
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City | KATY
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State | TX
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Zip | 77494-3827
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Country | US
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Telephone | 630-423-6474
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Fax |
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Provider Business Mailing Address
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Address Line | 8830 LONG POINT RD SUITE 502
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City | HOUSTON
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State | TX
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Zip | 77055-3040
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Country | US
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Telephone | 630-423-6474
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NISHA MEHTA
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Credential | DDS
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Telephone | 630-423-6474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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