Provider Demographics
NPI:1699331678
Name:GREATER HOUSTON PEDIATRIC DENTISTRY-CONROE PLLC
Entity type:Organization
Organization Name:GREATER HOUSTON PEDIATRIC DENTISTRY-CONROE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-464-5437
Mailing Address - Street 1:9742 KATY FWY STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6218
Mailing Address - Country:US
Mailing Address - Phone:713-464-5437
Mailing Address - Fax:713-464-5438
Practice Address - Street 1:381 S LOOP 336 W STE 1200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3351
Practice Address - Country:US
Practice Address - Phone:713-464-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty