Basic Information
| Provider Information | |||||||||
| NPI: | 1437870664 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KONTI | ||||||||
| FirstName: | POLYXENI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2526 BUSINESS CENTER DR APT 625 | ||||||||
| Address2: | |||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775842431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4752661657 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12626 WOODFOREST BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770153642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135900999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2022 | ||||||||
| LastUpdateDate: | 09/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 39002 | TX | Y | Dental Providers | Dentist |
No ID Information.