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General NPI Number Information
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NPI Number | 1447990445
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Entity Type | Organization
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Legal Business Name | FELICIA PRANATA, PLLC
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 1940 W LEAGUE CITY PKWY STE 170
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City | LEAGUE CITY
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State | TX
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Zip | 77573-7338
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Country | US
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Telephone | 281-241-9114
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 JUNIPER CANYON LN
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City | HOUSTON
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State | TX
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Zip | 77062-2059
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Country | US
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Telephone | 713-530-5168
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. FELICIA PRANATA
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Credential | DDS
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Telephone | 713-530-5168
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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 |
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License Number State |
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