MEDICARE: ENDODONTIC ASSOCIATES OF HOUSTON, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	20123	TX

General Provider Information

NPI Number	:	1093297798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDODONTIC ASSOCIATES OF HOUSTON, PLLC

Provider Business Mailing Address
First Line	:	1026 E WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4914
Country	:	US
Telephone Number	:	972-296-1835
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 BEECHNUT ST STE 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-4336
Country	:	US
Telephone Number	:	713-271-9100
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. YOGESH PATEL
Credential	:	DDS
Telephone Number	:	214-342-0425

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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