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General NPI Number Information
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NPI Number | 1669541033
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Entity Type | Individual
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Provider Name | RENE FOURNIER DMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 6500 NORTH FREEWAY #124
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City | HOUSTON
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State | TX
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Zip | 77076
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Country | US
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Telephone | 713-696-8111
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Fax | 713-696-8118
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Provider Business Mailing Address
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Address Line | 1218 SW MILITARY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78221-1535
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Country | US
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Telephone | 210-928-2814
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Fax | 210-927-4276
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2127
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License Number State | PR
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