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Organization

YOUR HOUSTON DENTIST

Active
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Organization

YOUR HOUSTON DENTIST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRADLEY RIX WILSON DDS, MSD (OWNER)
(713) 789-1200
Entity
Organization

Contact information

Practice address
2077 S GESSNER RD, SUITE 125, HOUSTON, TX 77063-1147
(713) 789-1200
(713) 789-1219
Mailing address
2077 S GESSNER RD, SUITE 125, HOUSTON, TX 77063-1147
(713) 789-1200
(713) 789-1219

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8242
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053329185
NPI TYPE 1
TX
Enumeration date
01/02/2008
Last updated
01/23/2008
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