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General NPI Number Information
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NPI Number | 1578008736
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Entity Type | Organization
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Legal Business Name | FAV-ULOUS DENTAL PLLC
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 8762 LONG POINT RD 102
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City | HOUSTON
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State | TX
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Zip | 77055-3030
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Country | US
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Telephone | 713-468-1400
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Fax | 713-468-8146
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Provider Business Mailing Address
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Address Line | 8762 LONG POINT RD 102
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City | HOUSTON
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State | TX
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Zip | 77055-3030
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Country | US
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Telephone | 713-468-1400
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Fax | 713-468-8146
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Authorized Official
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Title or Position | DENTIST
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Name | MRS. FABIOLA GARCIA DE ROCHA
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Credential | DDS
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Telephone | 713-468-1400
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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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 #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30122
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License Number State | TX
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