Provider Demographics
NPI:1063039006
Name:SCHULENBURG FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:SCHULENBURG FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KORAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:848-260-7476
Mailing Address - Street 1:4418 ARCHER MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6877
Mailing Address - Country:US
Mailing Address - Phone:979-743-4138
Mailing Address - Fax:
Practice Address - Street 1:717 UPTON AVE
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956-1565
Practice Address - Country:US
Practice Address - Phone:979-743-4138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental