Provider Demographics
NPI:1831661677
Name:HOUSTON'S PEDIATRIC DENTIST
Entity Type:Organization
Organization Name:HOUSTON'S PEDIATRIC DENTIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-457-0655
Mailing Address - Street 1:7700 SAN FELIPE ST STE 222
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1612
Mailing Address - Country:US
Mailing Address - Phone:713-785-3058
Mailing Address - Fax:
Practice Address - Street 1:7700 SAN FELIPE ST STE 222
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1612
Practice Address - Country:US
Practice Address - Phone:713-785-3058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty