Provider Demographics
NPI:1891211694
Name:TEXSMILES DENTAL PLLC
Entity Type:Organization
Organization Name:TEXSMILES DENTAL PLLC
Other - Org Name:BRILLIANCE DENTAL ARTS, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:YAN
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-628-6330
Mailing Address - Street 1:1509A FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1813
Mailing Address - Country:US
Mailing Address - Phone:626-628-6330
Mailing Address - Fax:
Practice Address - Street 1:3601 CENTER ST STE 106
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-6101
Practice Address - Country:US
Practice Address - Phone:626-628-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX290311223G0001X
TX290461223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty