Provider Demographics
NPI:1124633284
Name:CITRA ENDODONTICS PLLC
Entity type:Organization
Organization Name:CITRA ENDODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-671-7288
Mailing Address - Street 1:4130 FM 762 RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6434
Mailing Address - Country:US
Mailing Address - Phone:281-671-7288
Mailing Address - Fax:
Practice Address - Street 1:4130 FM 762 RD STE 500
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-6434
Practice Address - Country:US
Practice Address - Phone:281-671-7288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental