Provider Demographics
NPI:1407205800
Name:BRITEX OF WALDEN CREEK
Entity Type:Organization
Organization Name:BRITEX OF WALDEN CREEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-362-7130
Mailing Address - Street 1:9800 LAKE CREEK PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:512-362-7130
Mailing Address - Fax:512-362-7132
Practice Address - Street 1:9800 LAKE CREEK PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:512-362-7130
Practice Address - Fax:512-362-7132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS DENTAL PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24472261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental