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NPI Code Detail

MEDICARE: DENTAL HEALTH ASSOCIATES OF TX, P.C.

MEDICARE: DENTAL HEALTH ASSOCIATES OF TX, P.C.
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1447868435
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL HEALTH ASSOCIATES OF TX, P.C.
Provider Business Mailing Address
First Line : 1205 CLEAR LAKE CITY BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8105
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1205 CLEAR LAKE CITY BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8105
Country : US
Telephone Number : 281-488-1477
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : TABATHA LEMKE
Credential :
Telephone Number : 217-540-6078
Provider Enumeration Date : 07/16/2020
Last Update Date : 07/16/2020

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Directions to “DENTAL HEALTH ASSOCIATES OF TX, P.C. ” Practice Location

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