| Tqp Dentistry Pa | |
|
1909 N Main St Ste 107 Pearland TX 77581-3369 | |
| (646) 305-7069 | |
| Not Available |
| Full Name | Tqp Dentistry Pa |
|---|---|
| Speciality | Dentist |
| Location | 1909 N Main St Ste 107, Pearland, Texas |
| Authorized Official Name and Position | Thien Quoc Pham (PRESIDENT) |
| Authorized Official Contact | 6463057069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tqp Dentistry Pa 10223 Broadway St Ste P-248 Pearland TX 77584-7880 Ph: (646) 305-7069 | Tqp Dentistry Pa 1909 N Main St Ste 107 Pearland TX 77581-3369 Ph: (646) 305-7069 |
| NPI Number | 1124423967 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124423967 | NPI | - | NPPES |
| 1649465659 | Other | TX | PROVIDER NPI NUMBER |
| 23502 | Other | TX | DENTAL LICENSE NUMBER |
| 189843901 | Medicaid | TX | |
| G0154523 | Other | TX | TEXAS DEPARTMENT OF PUBLIC SAFETY CONTROLLED SUBSTANCE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 23502 (Texas) | Primary |
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