Provider Demographics
NPI:1508054180
Name:HO, HA PHAN (DDS, MMSC)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:PHAN
Last Name:HO
Suffix:
Gender:M
Credentials:DDS, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9127 KATY FWY
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1642
Mailing Address - Country:US
Mailing Address - Phone:713-468-1717
Mailing Address - Fax:713-468-7566
Practice Address - Street 1:9127 KATY FWY
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1642
Practice Address - Country:US
Practice Address - Phone:713-468-1717
Practice Address - Fax:713-468-7566
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX171441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics