Provider Demographics
NPI:1477698249
Name:ENG, VICTOR (DDS)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ENG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 HWY 6 SOUTH
Mailing Address - Street 2:SUITE C 100
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4390
Mailing Address - Country:US
Mailing Address - Phone:281-261-8258
Mailing Address - Fax:281-261-7859
Practice Address - Street 1:5425 HWY 6 SOUTH
Practice Address - Street 2:SUITE C 100
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4390
Practice Address - Country:US
Practice Address - Phone:281-261-8258
Practice Address - Fax:281-261-7859
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX164211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice