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Provider Information for 1841588142

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1841588142

Calendar   Last Updated:  2011-07-20
  Certification Date: 


Name Value
NPI 1841588142
Enumeration Date 2011-07-20
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 11900 HOBBY HORSE CT APT # 324
AUSTIN, TX 78758-2989
United States

Phone: 916-281-6080 | Fax:
View Map External Link
Primary Practice Address 1100 LOWES BLVD
KILLEEN, TX 76542-5491
United States

Phone: 254-449-8163 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 27250