| NPI | 1376089060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY JAMES HOLDER Owner/Manager 281-427-5305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 22806) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |