MEDICARE: DR. HAIYING HEIDI TANG D.D.S.

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	20187	TX

General Provider Information

NPI Number	:	1376905711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAIYING HEIDI TANG D.D.S.

Provider Business Mailing Address
First Line	:	6609 W SAM HOUSTON PKWY S STE 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1645
Country	:	US
Telephone Number	:	713-773-9889
Fax Number	:

Provider Business Practice Location Address
First Line	:	6609 W SAM HOUSTON PKWY S STE 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1645
Country	:	US
Telephone Number	:	713-773-9889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	03/24/2016

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Directions to “ DR. HAIYING HEIDI TANG D.D.S.” Practice Location

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