| NPI | 1760903439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURACHON WEERACHARTKUL Owner/President 713-392-1993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 24536) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 24536) |
| 261QD0000X Clinic/Center, Dental (Licence: TX 24263) | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |