Provider Demographics
NPI:1427557487
Name:LUIS EMILIO REY DMD PLLC
Entity type:Organization
Organization Name:LUIS EMILIO REY DMD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-631-9200
Mailing Address - Street 1:13630 VETERANS MEMORIAL DR STE H
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1054
Mailing Address - Country:US
Mailing Address - Phone:281-631-9200
Mailing Address - Fax:281-631-9201
Practice Address - Street 1:13630 VETERANS MEMORIAL DR STE H
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1054
Practice Address - Country:US
Practice Address - Phone:281-631-9200
Practice Address - Fax:281-631-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX293601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3784662Medicaid