Provider Demographics
NPI:1669640629
Name:ALONSO FAMILY DENTAL
Entity Type:Organization
Organization Name:ALONSO FAMILY DENTAL
Other - Org Name:ALONSO FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-687-5271
Mailing Address - Street 1:13043 PEBBLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079
Mailing Address - Country:US
Mailing Address - Phone:832-687-5271
Mailing Address - Fax:
Practice Address - Street 1:8817 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:281-778-8400
Practice Address - Fax:281-778-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty