Provider Demographics
NPI:1982187050
Name:TD FAMILY DENTISTRY
Entity Type:Organization
Organization Name:TD FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE EXPERT
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-218-0500
Mailing Address - Street 1:22167 WESTHEIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8300
Mailing Address - Country:US
Mailing Address - Phone:281-829-7887
Mailing Address - Fax:281-829-7882
Practice Address - Street 1:22167 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8300
Practice Address - Country:US
Practice Address - Phone:281-989-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental