Provider Demographics
NPI:1649531104
Name:HOUSTON PEDIATRIC DENTAL SPECIALISTS, PC
Entity type:Organization
Organization Name:HOUSTON PEDIATRIC DENTAL SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-346-8326
Mailing Address - Street 1:29818 FM 1093
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441
Mailing Address - Country:US
Mailing Address - Phone:281-346-8326
Mailing Address - Fax:
Practice Address - Street 1:29818 FM 1093
Practice Address - Street 2:SUITE 200
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441
Practice Address - Country:US
Practice Address - Phone:281-346-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131961223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty