1265142269 NPI number — TLN FAMILY & COSMETIC DENTISTRY AT MEYER PARK PLLC

Table of content: (NPI 1265142269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265142269 NPI number — TLN FAMILY & COSMETIC DENTISTRY AT MEYER PARK PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TLN FAMILY & COSMETIC DENTISTRY AT MEYER PARK PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265142269
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14522 S POST OAK RD STE 110A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77045-6001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-723-2600
Provider Business Mailing Address Fax Number:
832-377-4791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10259 S POST OAK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77096-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-723-2600
Provider Business Practice Location Address Fax Number:
832-377-4791
Provider Enumeration Date:
11/30/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
CHASITY
Authorized Official Middle Name:
Authorized Official Title or Position:
REGIONAL MANAGER
Authorized Official Telephone Number:
713-723-2600

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com