MEDICARE: TUAZON DDS 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	122300000X	Dentist

General Provider Information

NPI Number	:	1376329037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUAZON DDS PLLC

Provider Business Mailing Address
First Line	:	4502 RIVERSTONE BLVD STE 501
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5206
Country	:	US
Telephone Number	:	281-491-3626
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 RIVERSTONE BLVD STE 501
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5206
Country	:	US
Telephone Number	:	281-491-3626
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	MR. RANILO LISING TUAZON
Credential	:	DDS
Telephone Number	:	415-218-6543

Provider Enumeration Date	:	09/07/2023
Last Update Date	:	04/08/2026

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