Provider Demographics
NPI:1588111710
Name:VIEIRA OZORIO, JOSE ESTEVAM (DDS)
Entity type:Individual
Prefix:
First Name:JOSE ESTEVAM
Middle Name:
Last Name:VIEIRA OZORIO
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 1:9514 LAKESIDE ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1996
Mailing Address - Country:US
Mailing Address - Phone:346-291-4176
Mailing Address - Fax:
Practice Address - Street 1:4540 SPRING STUEBNER RD STE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1119
Practice Address - Country:US
Practice Address - Phone:954-529-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347211223E0200X, 1223E0200X
FL701122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223E0200XDental ProvidersDentistEndodontics