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General NPI Number Information
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NPI Number | 1548309347
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Entity Type | Individual
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Provider Name | THEODORE JOHN HOLUBEC D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7000 FANNIN ST SUITE 1840
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City | HOUSTON
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State | TX
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Zip | 77030-5400
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Country | US
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Telephone | 713-799-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 6262 WOODS BRIDGE WAY
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City | HOUSTON
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State | TX
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Zip | 77007-7041
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Country | US
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Telephone | 713-501-5572
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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 | 15422
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License Number State | TX
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