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General NPI Number Information
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NPI Number | 1467801720
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Entity Type | Organization
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Legal Business Name | BRITEX OF BULL CREEK
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 7300 RANCH ROAD 2222 216
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City | AUSTIN
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State | TX
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Zip | 78730-3204
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Country | US
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Telephone | 512-343-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 7300 RANCH ROAD 2222 216
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City | AUSTIN
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State | TX
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Zip | 78730-3204
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Country | US
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Telephone | 512-343-9000
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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. BRENDAN BOOKER LOEHR
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Credential | D.M.D.
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Telephone | 512-343-9000
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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 | 30932
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License Number State | TX
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