MEDICARE: DR. ROSS PICKEI 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
1	1223G0001X	General Practice Dentistry	30034	TX

General Provider Information

NPI Number	:	1952714859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSS PICKEI D.D.S.

Provider Business Mailing Address
First Line	:	5301 EVERGREEN ST
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4830
Country	:	US
Telephone Number	:	281-706-9356
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 BELLAIRE BLVD STE 212
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1056
Country	:	US
Telephone Number	:	713-667-3430
Fax Number	:

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

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	06/11/2021

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