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General NPI Number Information
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NPI Number | 1467059501
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Entity Type | Organization
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Legal Business Name | HUMBLE 9701, PLLC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 9701 N SAM HOUSTON PKWY E
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City | HUMBLE
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State | TX
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Zip | 77396-4636
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Country | US
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Telephone | 832-384-9767
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Fax | 832-827-6813
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Provider Business Mailing Address
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Address Line | 9701 N SAM HOUSTON PKWY E
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City | HUMBLE
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State | TX
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Zip | 77396-4636
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Country | US
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Telephone | 832-384-9767
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Fax | 832-827-6813
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Authorized Official
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Title or Position | MANAGER
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Name | KRUPA PATEL
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Credential | DDS
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Telephone | 402-216-6693
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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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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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