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NPI Code Detail

MEDICARE: DR. NATHALIE CLOUSE DUNWODY D.D.S.

MEDICARE: DR. NATHALIE CLOUSE DUNWODY 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
1122300000XDentist29693TX

General Provider Information

NPI Number : 1386061190
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHALIE CLOUSE DUNWODY D.D.S.
Provider Business Mailing Address
First Line : 2443 S GALVESTON AVE
Second Line :
City : PEARLAND
State : TX
Zip : 77581-4222
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2443 S GALVESTON AVE
Second Line :
City : PEARLAND
State : TX
Zip : 77581-4222
Country : US
Telephone Number : 915-449-1049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2014
Last Update Date : 06/16/2014

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