Provider Demographics
NPI:1598060261
Name:TEXDENTALCARE P.C
Entity Type:Organization
Organization Name:TEXDENTALCARE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIRMALA JYOTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARNENI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-943-8824
Mailing Address - Street 1:400 S ZANG BLVD STE 820
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6643
Mailing Address - Country:US
Mailing Address - Phone:214-943-8824
Mailing Address - Fax:214-943-4057
Practice Address - Street 1:400 S ZANG BLVD STE 820
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6643
Practice Address - Country:US
Practice Address - Phone:214-943-8824
Practice Address - Fax:214-943-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental