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12002 Veterans Memorial Dr #b3 Houston TX 77067-1161 | |
| (281) 580-7446 | |
| (281) 580-7520 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 12002 Veterans Memorial Dr, Houston, Texas |
| Authorized Official Name and Position | Peter Nguyen Van Tho (OWNER) |
| Authorized Official Contact | 2815617800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12002 Veterans Memorial Dr #b3 Houston TX 77067-1161 Ph: (281) 580-7446 | 12002 Veterans Memorial Dr #b3 Houston TX 77067-1161 Ph: (281) 580-7446 |
| NPI Number | 1477711430 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477711430 | NPI | - | NPPES |
| 1568526531 | Medicaid | TX | |
| 1295802734 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 17169 (Texas) | Primary |
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