Provider Demographics
NPI:1790174001
Name:BRIGHT VALUE DENTAL PA
Entity Type:Organization
Organization Name:BRIGHT VALUE DENTAL PA
Other - Org Name:DEREK XU LIANG DDS PA
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:XU
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-316-0369
Mailing Address - Street 1:3434 GOODHOPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-5908
Mailing Address - Country:US
Mailing Address - Phone:832-322-2310
Mailing Address - Fax:
Practice Address - Street 1:5716 BELLAIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5512
Practice Address - Country:US
Practice Address - Phone:832-316-0369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30113122300000X
TX30300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty