Provider Demographics
NPI:1225186695
Name:FARRELL, STEVEN R (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:FARRELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 W LAKE HOUSTON PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5220
Mailing Address - Country:US
Mailing Address - Phone:281-446-1169
Mailing Address - Fax:281-360-3392
Practice Address - Street 1:2815 W LAKE HOUSTON PKWY STE 105
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5220
Practice Address - Country:US
Practice Address - Phone:281-446-1169
Practice Address - Fax:281-360-3392
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry