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Organization
FM KATY DENTAL AND ORTHODONTICS, PLLC
Active
Organization
FM KATY DENTAL AND ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFFY KOUYOUMDJIAN (OWNER)
(817) 529-8151
Entity
Organization
Contact information
Practice address
100 E 15TH STE 520, FORT WORTH, TX 76102
(817) 529-8151
(817) 529-8156
Mailing address
20403 FM 529 ROAD, CYPRESS, TX 77433
(817) 529-8151
(817) 529-8156
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23066
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182419510
—
TX
05
—
182419511
—
TX
05
—
182419513
—
TX
05
—
182419514
—
TX
05
—
182419515
—
TX
Enumeration date
12/04/2014
Last updated
12/04/2014
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