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NPI Code Detail

MEDICARE: DR. GLORIA D IWUALA DDS

MEDICARE: DR. GLORIA D IWUALA DDS
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 Dentistry13492TX

General Provider Information

NPI Number : 1609929645
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLORIA D IWUALA DDS
Provider Business Mailing Address
First Line : 310 W 19TH ST
Second Line :
City : HOUSTON
State : TX
Zip : 77008-3906
Country : US
Telephone Number : 713-869-4085
Fax Number : 713-869-6414
Provider Business Practice Location Address
First Line : 310 W 19TH ST
Second Line :
City : HOUSTON
State : TX
Zip : 77008-3906
Country : US
Telephone Number : 713-869-4085
Fax Number : 713-869-6414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 01/06/2016

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Directions to “ DR. GLORIA D IWUALA DDS” Practice Location

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