| NPI | 1013371236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF LEWIS Owner/President 713-781-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 12371) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 22845) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |