MEDICARE: DR. DAVID DAJIA TSANG D.M.D.

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	1223G0001X	General Practice Dentistry	30053	TX

General Provider Information

NPI Number	:	1598049546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID DAJIA TSANG D.M.D.

Provider Business Mailing Address
First Line	:	4723 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3988
Country	:	US
Telephone Number	:	812-610-5552
Fax Number	:	281-261-5559

Provider Business Practice Location Address
First Line	:	4723 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3988
Country	:	US
Telephone Number	:	281-261-0555
Fax Number	:	281-261-5559

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

Provider Enumeration Date	:	10/07/2011
Last Update Date	:	02/04/2021

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