| Your Houston Dentist | |
|
2077 S Gessner Rd Suite 125 Houston TX 77063-1147 | |
| (713) 789-1200 | |
| (713) 789-1219 |
| Full Name | Your Houston Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2077 S Gessner Rd, Houston, Texas |
| Authorized Official Name and Position | Bradley Rix Wilson (OWNER) |
| Authorized Official Contact | 7137891200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Houston Dentist 2077 S Gessner Rd Suite 125 Houston TX 77063-1147 Ph: (713) 789-1200 | Your Houston Dentist 2077 S Gessner Rd Suite 125 Houston TX 77063-1147 Ph: (713) 789-1200 |
| NPI Number | 1003091604 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 01/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003091604 | NPI | - | NPPES |
| 1053329185 | Other | TX | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8242 (Texas) | Primary |
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