MEDICARE: GH RADFORD, DDS & ASSOCIATES INC

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	1223G0001X	General Practice Dentistry	7613	TX

General Provider Information

NPI Number	:	1285750661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GH RADFORD, DDS & ASSOCIATES INC

Provider Business Mailing Address
First Line	:	2280 HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4224
Country	:	US
Telephone Number	:	713-799-1400
Fax Number	:	713-799-1751

Provider Business Practice Location Address
First Line	:	2280 HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4224
Country	:	US
Telephone Number	:	713-799-1400
Fax Number	:	713-799-1751

Authorized Official
Title or Position	:	INSURANCE SUPERVISOR
Name	:	APRIL RAGLIN
Credential	:
Telephone Number	:	713-799-1400

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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