Provider Demographics
NPI:1558816835
Name:LEON XAVIER FOREMAN DENTAL PLLC
Entity Type:Organization
Organization Name:LEON XAVIER FOREMAN DENTAL PLLC
Other - Org Name:FLOSS FAMILY DENTALCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEON XAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:FOREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:713-730-0706
Mailing Address - Street 1:3300 S GESSNER RD
Mailing Address - Street 2:165B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5100
Mailing Address - Country:US
Mailing Address - Phone:713-732-0706
Mailing Address - Fax:
Practice Address - Street 1:6121 HILLCROFT ST
Practice Address - Street 2:STE. P
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1002
Practice Address - Country:US
Practice Address - Phone:832-834-4242
Practice Address - Fax:713-271-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00215211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty