Provider Demographics
NPI:1346857745
Name:SILVERLAKE G&S LLC
Entity Type:Organization
Organization Name:SILVERLAKE G&S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUN
Authorized Official - Middle Name:HA
Authorized Official - Last Name:HEO
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:281-463-6699
Mailing Address - Street 1:7058 LAKEVIEW HAVEN DR STE 107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2571
Mailing Address - Country:US
Mailing Address - Phone:281-463-6699
Mailing Address - Fax:
Practice Address - Street 1:7058 LAKEVIEW HAVEN DR STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2571
Practice Address - Country:US
Practice Address - Phone:281-463-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty