Provider Demographics
NPI:1538280201
Name:JAMES R. HERBST LL, D.D.S., P.C.
Entity Type:Organization
Organization Name:JAMES R. HERBST LL, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERBST
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-266-2265
Mailing Address - Street 1:2401 FOUNTAIN VIEW DR STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4819
Mailing Address - Country:US
Mailing Address - Phone:713-266-2265
Mailing Address - Fax:713-266-1560
Practice Address - Street 1:2401 FOUNTAIN VIEW DR STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4819
Practice Address - Country:US
Practice Address - Phone:713-266-2265
Practice Address - Fax:713-266-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty