NPI 1063176311

Carlos Medellin

Practitioner Dental Assistant Houston, TX

Practice location

Address: 2302 Keyhole Ln, Houston, TX 77084-5262
Phone: (281) 647-6656

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1063176311
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Oct 2021
Record last updated: 23 Oct 2021

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.