Full Name | |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1123 Alma St, Tomball, Texas |
Authorized Official Name and Position | Brad Bowsher (GENERAL MANAGER) |
Authorized Official Contact | 2813510005 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1123 Alma St Tomball TX 77375-4518 Ph: (281) 351-2200 | 1123 Alma St Tomball TX 77375-4518 Ph: (281) 351-2200 |
NPI Number | 1003205485 |
---|---|
Provider Enumeration Date | 01/22/2015 |
Last Update Date | 01/22/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003205485 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | 19953 (Texas) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 21280 (Texas) | Primary |
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