| NPI | 1730220633 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KIMBERLY DEANN SWANN Insurance Coordinator 281-320-2000  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14370)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 18848)  | 
| Enumeration Date | 2007-02-12 | 
| Last Update Date | 2020-08-22 |