| NPI | 1710283429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA L LEWIS President 281-890-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 13196) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 25655) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |