Provider Demographics
NPI:1093935389
Name:TEXAS DENTAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:TEXAS DENTAL ASSOCIATES, PA
Other - Org Name:LOVETT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LESAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-490-8880
Mailing Address - Street 1:2536 AMHERST ST
Mailing Address - Street 2:STE. A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3207
Mailing Address - Country:US
Mailing Address - Phone:713-490-8880
Mailing Address - Fax:713-490-6464
Practice Address - Street 1:5681 FAIRMONT PKWY STE B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3903
Practice Address - Country:US
Practice Address - Phone:281-998-8800
Practice Address - Fax:281-998-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108491223G0001X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty