Provider Demographics
NPI:1164806485
Name:STUCHLIK, KATIE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:E
Last Name:STUCHLIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:E
Other - Last Name:SOWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1717 WEST 34TH STREET, SUITE 450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:832-271-8220
Mailing Address - Fax:281-395-4706
Practice Address - Street 1:1717 WEST 34TH STREET, SUITE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:832-271-8220
Practice Address - Fax:281-395-4706
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist