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9888 Bellaire Blvd Ste 120 Houston TX 77036-3431 | |
| (713) 773-9971 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 9888 Bellaire Blvd Ste 120, Houston, Texas |
| Authorized Official Name and Position | Steven Xue (OWNER) |
| Authorized Official Contact | 7137739971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9888 Bellaire Blvd Ste 120 Houston TX 77036-3431 Ph: (713) 773-9971 | 9888 Bellaire Blvd Ste 120 Houston TX 77036-3431 Ph: (713) 773-9971 |
| NPI Number | 1861943730 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Medicare PECOS PAC ID | 5092123083 |
|---|---|
| Medicare Enrollment ID | O20210412000999 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861943730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20668 (Texas) | Primary |
| Provider Name | Steven Zhi Gang Xue |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083839278 PECOS PAC ID: 3678981669 Enrollment ID: I20210412001431 |
| Provider Name | Kevin Lin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184179756 PECOS PAC ID: 7911347414 Enrollment ID: I20240501001903 |
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