Provider Demographics
NPI:1770939035
Name:TEXAS CHOICE DENTAL PLLC
Entity type:Organization
Organization Name:TEXAS CHOICE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PUKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJBHANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:346-234-3266
Mailing Address - Street 1:19725 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3566
Mailing Address - Country:US
Mailing Address - Phone:346-234-3266
Mailing Address - Fax:
Practice Address - Street 1:19725 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3566
Practice Address - Country:US
Practice Address - Phone:346-234-3266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX278877122300000X
TX27213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1518245034OtherDENTIST
TX1205124856OtherDENTIST