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General NPI Number Information
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NPI Number | 1831372911
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Entity Type | Organization
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Legal Business Name | THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 6516 M D ANDERSON BLVD SUITE 156
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City | HOUSTON
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State | TX
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Zip | 77030-3402
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Country | US
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Telephone | 710-500-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 6516 M D ANDERSON BLVD SUITE 156
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City | HOUSTON
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State | TX
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Zip | 77030-3402
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Country | US
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Telephone | 710-500-4001
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DEAN OF PATIENT CARE
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Name | DR. PEGGY O'NEILL
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Credential | DDS
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Telephone | 713-500-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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