MEDICARE: FLASH DENTAL BRAESWOOD

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1902510779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLASH DENTAL BRAESWOOD

Provider Business Mailing Address
First Line	:	9099 KATY FWY STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1632
Country	:	US
Telephone Number	:	713-465-1860
Fax Number	:

Provider Business Practice Location Address
First Line	:	4004 S BRAESWOOD BLVD STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-3304
Country	:	US
Telephone Number	:	713-465-1860
Fax Number	:

Authorized Official
Title or Position	:	FINANCE OFFICER, HR DIRECTOR
Name	:	MS. THERESA NAVARRO
Credential	:	AABA
Telephone Number	:	713-677-9983

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	01/06/2023

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Directions to “FLASH DENTAL BRAESWOOD ” Practice Location

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