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6516 M D Anderson Blvd Suite 156 Houston TX 77030-3402 | |
| (710) 500-4001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 6516 M D Anderson Blvd, Houston, Texas |
| Authorized Official Name and Position | Peggy O'neill (ASSOCIATE DEAN OF PATIENT CARE) |
| Authorized Official Contact | 7135004001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6516 M D Anderson Blvd Suite 156 Houston TX 77030-3402 Ph: (710) 500-4001 | 6516 M D Anderson Blvd Suite 156 Houston TX 77030-3402 Ph: (710) 500-4001 |
| NPI Number | 1831372911 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 12/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831372911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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