Provider Demographics
NPI:1891253407
Name:SOH OF TEXAS SAMSON LIU PLLC
Entity Type:Organization
Organization Name:SOH OF TEXAS SAMSON LIU PLLC
Other - Org Name:NW HILLS DENTAL AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNSHINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-413-2803
Mailing Address - Street 1:7011 HART LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3018
Mailing Address - Country:US
Mailing Address - Phone:512-345-2655
Mailing Address - Fax:
Practice Address - Street 1:7011 HART LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3018
Practice Address - Country:US
Practice Address - Phone:512-345-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOH OF TEXAS SAMSON LIU PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-04
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty