| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4058 Little York, Houston, Texas |
| Authorized Official Name and Position | Thao Hien Nguyen (PRESIDENT) |
| Authorized Official Contact | 2818288889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4058 Little York Houston TX 77093 Ph: (713) 742-8887 | 4058 Little York Houston TX 77093 Ph: (713) 742-8887 |
| NPI Number | 1568649879 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 04/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568649879 | NPI | - | NPPES |
| 133326210 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20228 (Texas) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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