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General NPI Number Information
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NPI Number | 1649531104
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Entity Type | Organization
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Legal Business Name | HOUSTON PEDIATRIC DENTAL SPECIALISTS, PC
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 29818 FM 1093 SUITE 200
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City | FULSHEAR
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State | TX
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Zip | 77441
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Country | US
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Telephone | 281-346-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 29818 FM 1093 SUITE 200
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City | FULSHEAR
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State | TX
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Zip | 77441
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Country | US
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Telephone | 281-346-8326
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. REGINA L LEWIS
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Credential | DDS
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Telephone | 281-346-8326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 13196
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License Number State | TX
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