Provider Demographics
NPI:1821159716
Name:SATCHELL & ELLIS DENTAL SERVICES PC
Entity Type:Organization
Organization Name:SATCHELL & ELLIS DENTAL SERVICES PC
Other - Org Name:NORTHWEST GENERAL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-661-1090
Mailing Address - Street 1:15614 FM 529 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2706
Mailing Address - Country:US
Mailing Address - Phone:281-856-6300
Mailing Address - Fax:281-855-7785
Practice Address - Street 1:15614 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2706
Practice Address - Country:US
Practice Address - Phone:281-856-6300
Practice Address - Fax:281-855-7785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197741223G0001X
TX219521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty