Provider Demographics
NPI:1922884568
Name:PDG-59, PLLC
Entity Type:Organization
Organization Name:PDG-59, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAI
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-498-9825
Mailing Address - Street 1:6908 BRISBANE CT STE 150
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4922
Mailing Address - Country:US
Mailing Address - Phone:281-207-4161
Mailing Address - Fax:281-207-4162
Practice Address - Street 1:6908 BRISBANE CT STE 150
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4922
Practice Address - Country:US
Practice Address - Phone:281-207-4161
Practice Address - Fax:281-207-4162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty