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General NPI Number Information
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NPI Number | 1609865070
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Entity Type | Individual
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Provider Name | REENA THOMAS GEORGE DDS
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Gender | Female
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 12626 WOODFOREST BLVD #Z
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City | HOUSTON
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State | TX
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Zip | 77015-3425
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Country | US
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Telephone | 713-590-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 CRESCENT PLAZA DR APT #1169
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City | HOUSTON
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State | TX
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Zip | 77077-2476
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Country | US
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Telephone | 512-535-5747
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019025741
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 23742
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License Number State | TX
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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 | 23742
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 23742
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License Number State | TX
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