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General NPI Number Information
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NPI Number | 1629759873
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Entity Type | Organization
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Legal Business Name | RST SOUL DENTAL PLLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 10350 S POST OAK RD STE H
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City | HOUSTON
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State | TX
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Zip | 77035-3319
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Country | US
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Telephone | 713-551-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 5018 BRAESHEATHER DR
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City | HOUSTON
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State | TX
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Zip | 77096-4205
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Country | US
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Telephone | 479-445-8588
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | LUCILLA GARZA
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Credential |
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Telephone | 479-445-8588
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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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