MEDICARE: JULAI DSTX, 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1336824879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULAI DSTX, PLLC

Provider Business Mailing Address
First Line	:	15455 MEMORIAL DR STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-4137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15455 MEMORIAL DR STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-4137
Country	:	US
Telephone Number	:	281-940-8940
Fax Number	:

Authorized Official
Title or Position	:	OWNER / CEO
Name	:	JUSTIN LAI
Credential	:	DDS
Telephone Number	:	281-849-8313

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	06/21/2023

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