Provider Demographics
NPI:1891580700
Name:THE AIRWAY DENTISTS OF TEXAS, PLLC
Entity type:Organization
Organization Name:THE AIRWAY DENTISTS OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-703-9468
Mailing Address - Street 1:501 S FRIENDSWOOD DR STE 105
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4695
Mailing Address - Country:US
Mailing Address - Phone:281-816-3040
Mailing Address - Fax:281-816-3046
Practice Address - Street 1:16402 W LAKE HOUSTON PKWY STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6479
Practice Address - Country:US
Practice Address - Phone:346-266-0880
Practice Address - Fax:346-266-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty