Provider Demographics
NPI:1841312436
Name:PHAN, DEBBIE NGOC-DIEP (DDS)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:NGOC-DIEP
Last Name:PHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 FANNIN ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1913
Mailing Address - Country:US
Mailing Address - Phone:713-797-6453
Mailing Address - Fax:713-797-1900
Practice Address - Street 1:7505 FANNIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1913
Practice Address - Country:US
Practice Address - Phone:713-797-6453
Practice Address - Fax:713-797-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice