| Angela Ishak Dmd Pllc | |
|
6940 Katy Gaston Rd Ste 200 Katy TX 77494-6480 | |
| (281) 271-5100 | |
| (281) 271-5110 |
| Full Name | Angela Ishak Dmd Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6940 Katy Gaston Rd Ste 200, Katy, Texas |
| Authorized Official Name and Position | Angela Ishak (OWNER/DENTIST) |
| Authorized Official Contact | 2812715100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Ishak Dmd Pllc 6940 Katy Gaston Rd Ste 200 Katy TX 77494-6480 Ph: (281) 271-5100 | Angela Ishak Dmd Pllc 6940 Katy Gaston Rd Ste 200 Katy TX 77494-6480 Ph: (281) 271-5100 |
| NPI Number | 1427712827 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 10/22/2021 |
| Medicare PECOS PAC ID | 1254721749 |
|---|---|
| Medicare Enrollment ID | O20211123001973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427712827 | NPI | - | NPPES |
| 25225 | Other | TX | DENTAL LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Angela Ishak |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1205138252 PECOS PAC ID: 9335539824 Enrollment ID: I20211123002290 |
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