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1011 Augusta Dr Ste 201 Houston TX 77057-2061 | |
| (713) 714-3270 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1011 Augusta Dr Ste 201, Houston, Texas |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1011 Augusta Dr Ste 201 Houston TX 77057-2061 Ph: () - | 1011 Augusta Dr Ste 201 Houston TX 77057-2061 Ph: (713) 714-3270 |
| NPI Number | 1891346102 |
|---|---|
| Provider Enumeration Date | 09/27/2019 |
| Last Update Date | 09/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891346102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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