| NPI | 1114030178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BONEY Dir Hr/Professional Relations 281-296-8600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-08-29 |