Provider Demographics
NPI:1124515887
Name:ENDODONTICS OF HOUSTON, LLP
Entity type:Organization
Organization Name:ENDODONTICS OF HOUSTON, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TOD
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRUCHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-655-0063
Mailing Address - Street 1:9318 LOUETTA RD STE 500
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6547
Mailing Address - Country:US
Mailing Address - Phone:281-655-0063
Mailing Address - Fax:281-655-0093
Practice Address - Street 1:9318 LOUETTA RD STE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6547
Practice Address - Country:US
Practice Address - Phone:281-655-0063
Practice Address - Fax:281-655-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty