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11682 Southwest Fwy Houston TX 77031-3612 | |
| (281) 741-2576 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11682 Southwest Fwy, Houston, Texas |
| Authorized Official Name and Position | Rene Alejandro Rodriguez Farrach (DENTIST/OWNER) |
| Authorized Official Contact | 8324574051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11682 Southwest Fwy Houston TX 77031-3612 Ph: (281) 741-2576 | 11682 Southwest Fwy Houston TX 77031-3612 Ph: (281) 741-2576 |
| NPI Number | 1073882924 |
|---|---|
| Provider Enumeration Date | 12/21/2011 |
| Last Update Date | 12/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073882924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 26467 (Texas) | Primary |
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