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NPI Code Detail

MEDICARE: DR. HAROLD A. BLACK D.D.S.

MEDICARE: DR. HAROLD A. BLACK 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
11223G0001XGeneral Practice Dentistry13062TX

General Provider Information

NPI Number : 1861563553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAROLD A. BLACK D.D.S.
Provider Business Mailing Address
First Line : 808 6TH ST
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-5402
Country : US
Telephone Number : 979-826-3306
Fax Number : 979-826-3308
Provider Business Practice Location Address
First Line : 808 6TH ST
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-5402
Country : US
Telephone Number : 979-826-3306
Fax Number : 979-826-3308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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Directions to “ DR. HAROLD A. BLACK D.D.S.” Practice Location

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