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General NPI Number Information
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NPI Number | 1972784346
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Entity Type | Organization
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Legal Business Name | UVALDE DENTAL
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 174 UVALDE RD
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City | HOUSTON
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State | TX
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Zip | 77015-1506
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Country | US
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Telephone | 713-451-2955
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Fax | 713-451-3655
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Provider Business Mailing Address
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Address Line | 174 UVALDE RD
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City | HOUSTON
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State | TX
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Zip | 77015-1506
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Country | US
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Telephone | 713-451-2955
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Fax | 713-451-3655
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Authorized Official
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Title or Position | DENTIST
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Name | ALINE T TRAN
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Credential | DDS
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Telephone | 713-451-2955
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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 | 19142
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License Number State | TX
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