Provider Demographics
NPI:1093535387
Name:RADHIKA GOWALI DDS PLLC
Entity type:Organization
Organization Name:RADHIKA GOWALI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOWALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-520-3445
Mailing Address - Street 1:2208 CONVERSE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1904
Mailing Address - Country:US
Mailing Address - Phone:713-303-8825
Mailing Address - Fax:
Practice Address - Street 1:21211 FM 529 RD STE 106
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6802
Practice Address - Country:US
Practice Address - Phone:281-520-3445
Practice Address - Fax:281-345-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty