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2710 Mangum Rd Suite 109 Houston TX 77092-7404 | |
| (713) 956-0400 | |
| (713) 956-7617 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2710 Mangum Rd, Houston, Texas |
| Authorized Official Name and Position | Allen F. Gaw (OWNER) |
| Authorized Official Contact | 7139560400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2710 Mangum Rd Suite 109 Houston TX 77092-7404 Ph: (713) 956-0400 | 2710 Mangum Rd Suite 109 Houston TX 77092-7404 Ph: (713) 956-0400 |
| NPI Number | 1669696431 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 10/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669696431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 11081 (Texas) | Primary |
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