Provider Demographics
NPI:1023331774
Name:HUY QUACH DDS PC
Entity type:Organization
Organization Name:HUY QUACH DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-549-7402
Mailing Address - Street 1:2120 EL PASEO ST
Mailing Address - Street 2:APT 1504
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3241
Mailing Address - Country:US
Mailing Address - Phone:832-549-7402
Mailing Address - Fax:
Practice Address - Street 1:15634 WALLISVILLE RD
Practice Address - Street 2:900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-4635
Practice Address - Country:US
Practice Address - Phone:832-549-7402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24085OtherDENTAL LICENSE NUMBER
TXFQ0997633OtherDEA NUMBER