| Fairfield Professional Llc | |
|
28070 Highway 290 Ste 150 Cypress TX 77433-6921 | |
| (281) 373-4000 | |
| Not Available |
| Full Name | Fairfield Professional Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 28070 Highway 290 Ste 150, Cypress, Texas |
| Authorized Official Name and Position | Tanya Amador (OFFICE MANAGER) |
| Authorized Official Contact | 7136948800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield Professional Llc 28070 Highway 290 Ste 150 Cypress TX 77433-6921 Ph: (281) 373-4000 | Fairfield Professional Llc 28070 Highway 290 Ste 150 Cypress TX 77433-6921 Ph: (281) 373-4000 |
| NPI Number | 1740717883 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740717883 | NPI | - | NPPES |
| 007805705 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 19674 (Texas) | Primary |
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