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21450 Kuykendahl Rd Ste 140 Spring TX 77379-2663 | |
| (512) 237-2448 | |
| (512) 237-2543 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21450 Kuykendahl Rd Ste 140, Spring, Texas |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
21450 Kuykendahl Rd Ste 140 Spring TX 77379-2663 Ph: (512) 237-2448 | 21450 Kuykendahl Rd Ste 140 Spring TX 77379-2663 Ph: (512) 237-2448 |
| NPI Number | 1013382191 |
|---|---|
| Provider Enumeration Date | 12/01/2015 |
| Last Update Date | 01/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013382191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30141 (Texas) | Primary |
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