# ALBERT A ALFONSO DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053571489
- **Authorized official:** DR. ALBERT A ALFONSO DDS (OWNER)
- **Authorized official phone:** (281) 807-6555

## Contact information

- **Practice address:** 10926 GRANT RD, HOUSTON, TX 77070-4445
- **Practice address phone:** (281) 807-6555
- **Practice address fax:** (281) 469-5907
- **Mailing address:** 10926 GRANT RD, HOUSTON, TX 77070-4445
- **Mailing address phone:** (281) 807-6555
- **Mailing address fax:** (281) 469-5907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 20647 | TX | Yes |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1295824753 | INDIVIDUAL NPI | TX |
| 05 | — | 147952905 | — | TX |