| R. Terry Councill, DDS, PA | |
|
12835 Louetta Rd Cypress TX 77429-5207 | |
| (281) 376-9246 | |
| (281) 370-8398 |
| Full Name | R. Terry Councill, DDS, PA |
|---|---|
| Speciality | Dentist |
| Location | 12835 Louetta Rd, Cypress, Texas |
| Authorized Official Name and Position | Susan Desporte (BUSINESS MANAGER) |
| Authorized Official Contact | 2813769246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Terry Councill, DDS, PA 10924 Grant Rd Ste 310 Houston TX 77070-4445 Ph: (281) 376-9246 | R. Terry Councill, DDS, PA 12835 Louetta Rd Cypress TX 77429-5207 Ph: (281) 376-9246 |
| NPI Number | 1689191454 |
|---|---|
| Provider Enumeration Date | 08/23/2017 |
| Last Update Date | 08/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689191454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13448 (Texas) | Primary |
| 122300000X | Dentist | 28492 (Texas) | Secondary |
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