Provider Demographics
NPI:1639276165
Name:TURULLOLS, LETICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:
Last Name:TURULLOLS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 W LITTLE YORK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-2423
Mailing Address - Country:US
Mailing Address - Phone:713-694-9070
Mailing Address - Fax:713-694-1487
Practice Address - Street 1:633 W LITTLE YORK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-2423
Practice Address - Country:US
Practice Address - Phone:713-694-9070
Practice Address - Fax:713-694-1487
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0130421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX091039001Medicaid
TX091039004Medicaid