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General NPI Number Information
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NPI Number | 1932462926
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Entity Type | Organization
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Legal Business Name | JULIE M. LONGORIA DDS, MSD, PA
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Dates
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Enumeration Date | 06/24/2012
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Last Update Date | 06/24/2012
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Provider Practice Location Address
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Address Line | 5311 KIRBY DR 211
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City | HOUSTON
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State | TX
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Zip | 77005-1364
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Country | US
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Telephone | 806-441-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 4309 OLEANDER ST
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City | BELLAIRE
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State | TX
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Zip | 77401-5226
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Country | US
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Telephone | 806-441-0399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIE LONGORIA
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Credential | DDS
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Telephone | 806-441-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 23928
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License Number State | TX
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