NPI 1003091604

Your Houston Dentist

Organisation General Practice Dentistry Houston, TX

Practice location

Address: 2077 S Gessner Rd Suite 125, Houston, TX 77063-1147
Phone: (713) 789-1200
Fax: (713) 789-1219

Authorised official

Name: Bradley Rix Wilson
Title: Owner
Phone: (713) 789-1200

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 8242 (TX)

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Registry record

NPI: 1003091604
Entity type: Organization
NPI issued: 2 Jan 2008
Record last updated: 23 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.