| NPI | 1164819488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN QUANG TRAN Manager 979-316-2973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27364) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |