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General NPI Number Information
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NPI Number | 1710252697
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Entity Type | Organization
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Legal Business Name | TVO STELLA CORPORATION
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 8505 GULF FWY SUITE D
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City | HOUSTON
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State | TX
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Zip | 77017-5085
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Country | US
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Telephone | 832-526-3839
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721624
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City | HOUSTON
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State | TX
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Zip | 77272-1624
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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 | MANAGER
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Name | MR. TWEE NGUYEN
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Credential |
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Telephone | 832-526-3839
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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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