MEDICARE: ST. HOPE FOUNDATION,INC

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	27727	TX

General Provider Information

NPI Number	:	1740648336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. HOPE FOUNDATION,INC

Provider Business Mailing Address
First Line	:	255 NORTHPOINT DR
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77060-3203
Country	:	US
Telephone Number	:	832-300-8040
Fax Number	:	713-844-8034

Provider Business Practice Location Address
First Line	:	6200 SAVOY DR
Second Line	:	SUITE 540
City	:	HOUSTON
State	:	TX
Zip	:	77036-3300
Country	:	US
Telephone Number	:	713-778-1300
Fax Number	:	713-778-0827

Authorized Official
Title or Position	:	DIRECTOR OF DENTAL SERVICES
Name	:	MS. NICOLE C FRENCH
Credential	:	RDA
Telephone Number	:	713-778-1300

Provider Enumeration Date	:	02/10/2016
Last Update Date	:	02/10/2016

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