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General NPI Number Information
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NPI Number | 1518371822
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Entity Type | Individual
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Provider Name | ELYSE SEARS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 2355 HIGHWAY 36 S
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City | SEALY
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State | TX
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Zip | 77474-4224
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Country | US
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Telephone | 979-987-6030
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Fax | 979-476-2035
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Provider Business Mailing Address
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Address Line | 3014 DOLORES PARK LN
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City | HOUSTON
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State | TX
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Zip | 77057-1475
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Country | US
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Telephone | 318-792-2654
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Fax |
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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 | 30747
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License Number State | TX
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