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General NPI Number Information
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NPI Number | 1578869285
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Entity Type | Organization
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Legal Business Name | HCDC PROFESSIONALS PLLC
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3800 N SHEPHERD DR STE B
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City | HOUSTON
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State | TX
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Zip | 77018-6411
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Country | US
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Telephone | 713-814-4717
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Fax | 713-568-1633
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Provider Business Mailing Address
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Address Line | 9709 LAKESIDE BLVD STE 350
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City | SPRING
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State | TX
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Zip | 77381-1213
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Country | US
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Telephone | 134-892-1987
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Fax | 713-489-2978
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Authorized Official
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Title or Position | OWNER
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Name | DR. KETAN SUKKAWALA
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Credential | D.D.S.
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Telephone | 979-450-1116
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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 | 26232
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License Number State | TX
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