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24207 Kingsland Boulevard Katy TX 77494 | |
| (281) 396-4366 | |
| (281) 396-4367 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 24207 Kingsland Boulevard, Katy, Texas |
| Authorized Official Name and Position | Lauren Shepard (OWNER/DENTIST) |
| Authorized Official Contact | 2813964366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
24207 Kingsland Boulevard Katy TX 77494 Ph: (281) 396-4366 | 24207 Kingsland Boulevard Katy TX 77494 Ph: (281) 396-4366 |
| NPI Number | 1144585688 |
|---|---|
| Provider Enumeration Date | 07/11/2012 |
| Last Update Date | 11/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144585688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 24019 (Texas) | Secondary |
| 1223G0001X | Dentist - General Practice | 16804 (Texas) | Primary |
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