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515 Westheimer Rd Suite D Houston TX 77006-2931 | |
| (713) 524-7554 | |
| (713) 526-4780 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 515 Westheimer Rd, Houston, Texas |
| Authorized Official Name and Position | Christi Van Clifford (PRESIDENT) |
| Authorized Official Contact | 7135247554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
515 Westheimer Rd Suite D Houston TX 77006-2931 Ph: (713) 524-7554 | 515 Westheimer Rd Suite D Houston TX 77006-2931 Ph: (713) 524-7554 |
| NPI Number | 1497888770 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497888770 | NPI | - | NPPES |
| 17894-01 | Other | TX | TEXAS CHIP PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 261QD0000X (Texas) | Primary |
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