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4950 Beechnut St Houston TX 77096-1605 | |
| (281) 503-4804 | |
| (281) 573-0775 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4950 Beechnut St, Houston, Texas |
| Authorized Official Name and Position | Ashley Elizondo (OWNER) |
| Authorized Official Contact | 2815034804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8500 | 4950 Beechnut St Houston TX 77096-1605 Ph: (281) 503-4804 |
| NPI Number | 1326686031 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 02/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326686031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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