# FM KATY DENTAL AND ORTHODONTICS, PLLC

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

## Provider details

- **NPI number:** 1265839344
- **Authorized official:** RAFFY KOUYOUMDJIAN (OWNER)
- **Authorized official phone:** (817) 529-8151

## Contact information

- **Practice address:** 100 E 15TH STE 520, FORT WORTH, TX 76102
- **Practice address phone:** (817) 529-8151
- **Practice address fax:** (817) 529-8156
- **Mailing address:** 20403 FM 529 ROAD, CYPRESS, TX 77433
- **Mailing address phone:** (817) 529-8151
- **Mailing address fax:** (817) 529-8156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 23066 | TX | Yes |

## Other

- **Enumeration date:** 12/04/2014
- **Last updated:** 12/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 182419510 | — | TX |
| 05 | — | 182419511 | — | TX |
| 05 | — | 182419513 | — | TX |
| 05 | — | 182419514 | — | TX |
| 05 | — | 182419515 | — | TX |