| NPI | 1659588820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS MARIO VELASQUEZ D.D.S.,Ms. 713-785-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18000) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 18000) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 18000) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |