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General NPI Number Information
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NPI Number | 1750591988
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Entity Type | Individual
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Provider Name | RHEA ELYCE RADFORD D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 10223 BROADWAY ST STE D1
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City | PEARLAND
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State | TX
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Zip | 77584-7881
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Country | US
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Telephone | 713-436-2522
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Fax | 713-799-1751
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Provider Business Mailing Address
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Address Line | 10223 BROADWAY D-1
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City | PEARLAND
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State | TX
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Zip | 77584
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Country | US
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Telephone | 713-436-2522
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Fax | 713-799-1751
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 16110
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License Number State | TX
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