MEDICARE: DR. PERRY BRITT NOLEN 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
1	122300000X	Dentist	11922	TX

General Provider Information

NPI Number	:	1942304399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PERRY BRITT NOLEN DDS

Provider Business Mailing Address
First Line	:	1530 SOUTH GRAND PARKWAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-8257
Country	:	US
Telephone Number	:	281-693-7373
Fax Number	:	281-693-6299

Provider Business Practice Location Address
First Line	:	1530 SOUTH GRAND PARKWAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-8257
Country	:	US
Telephone Number	:	281-693-7373
Fax Number	:	281-693-6299

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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