Provider Demographics
NPI:1275966780
Name:JUST BRACES OF TEXAS, PLLC
Entity Type:Organization
Organization Name:JUST BRACES OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-775-2888
Mailing Address - Street 1:9025 N SAM HOUSTON PKWY E
Mailing Address - Street 2:160
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4399
Mailing Address - Country:US
Mailing Address - Phone:281-359-5551
Mailing Address - Fax:
Practice Address - Street 1:9025 N SAM HOUSTON PKWY E
Practice Address - Street 2:160
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4399
Practice Address - Country:US
Practice Address - Phone:281-359-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23564122300000X, 1223P0221X, 1223X0400X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty