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3440 Riley Fuzzel Rd Ste 200 Spring TX 77386-4189 | |
(832) 652-7330 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 3440 Riley Fuzzel Rd Ste 200, Spring, Texas |
Authorized Official Name and Position | Nishano Thomas (OWNER) |
Authorized Official Contact | 8326527330 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3440 Riley Fuzzel Rd Ste 200 Spring TX 77386-4189 Ph: (832) 652-7330 | 3440 Riley Fuzzel Rd Ste 200 Spring TX 77386-4189 Ph: (832) 652-7330 |
NPI Number | 1639681661 |
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Provider Enumeration Date | 10/31/2017 |
Last Update Date | 10/31/2017 |
Identifier | Type | State | Issuer |
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1639681661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 21579 (Texas) | Primary |
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