Provider Demographics
NPI:1780121509
Name:GREATER HOUSTON PEDIATRIC DENTISTRY KATY PLLC
Entity type:Organization
Organization Name:GREATER HOUSTON PEDIATRIC DENTISTRY KATY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:MY
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-464-5437
Mailing Address - Street 1:2722 W. GRAND PARKWAY NORTH
Mailing Address - Street 2:#160
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2722 W. GRAND PARKWAY NORTH
Practice Address - Street 2:#160
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493
Practice Address - Country:US
Practice Address - Phone:713-464-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty