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10019 S Main St A6 Houston TX 77025 | |
| (713) 433-6431 | |
| (713) 665-6432 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10019 S Main St, Houston, Texas |
| Authorized Official Name and Position | Joe E Eckford (PRESIDENT / DENTIST) |
| Authorized Official Contact | 7134336431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10019 S Main St A6 Houston TX 77025-5256 Ph: (713) 433-6431 | 10019 S Main St A6 Houston TX 77025 Ph: (713) 433-6431 |
| NPI Number | 1841598349 |
|---|---|
| Provider Enumeration Date | 03/08/2011 |
| Last Update Date | 02/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841598349 | NPI | - | NPPES |
| 211820007 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 25289 (Texas) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 25289 (Texas) | Secondary |
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