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General NPI Number Information
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NPI Number | 1578092748
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Entity Type | Organization
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Legal Business Name | FABF MANAGEMENT, LLC
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1708 SPRING GREEN BLVD #200
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-492-1111
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Fax | 281-492-1131
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Provider Business Mailing Address
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Address Line | 1708 SPRING GREEN BLVD STE 200
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City | KATY
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State | TX
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Zip | 77494-7463
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Country | US
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Telephone | 281-492-1111
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Fax | 281-492-1131
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TANYA AMADOR
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Credential |
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Telephone | 713-694-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 19674
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License Number State | TX
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