Basic Information
| Provider Information | |||||||||
| NPI: | 1194986877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUACH | ||||||||
| FirstName: | HUY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2120 EL PASEO ST | ||||||||
| Address2: | APT 1504 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770543241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325497402 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5357 W BELLFORT ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770353001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137233777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 06/24/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 0024085 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.