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General NPI Number Information
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NPI Number | 1619510203
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Entity Type | Organization
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Legal Business Name | KATY DENTAL ARTS, PLLC
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 23501 CINCO RANCH BLVD STE B228
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City | KATY
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State | TX
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Zip | 77494-3278
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Country | US
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Telephone | 281-561-5289
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Fax |
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Provider Business Mailing Address
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Address Line | 6818 ATASCOCITA RD
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City | HUMBLE
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State | TX
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Zip | 77346-2817
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | ANGELA CHRISTINE UMANSKY
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Credential |
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Telephone | 832-641-2503
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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 |
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License Number State |
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