# VICKERS FAMILY DENTAL

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

## Provider details

- **NPI number:** 1689238289
- **Authorized official:** MRS. STEPHANIE ANN VICKERS RDA (OFFICE MANAGER)
- **Authorized official phone:** (281) 440-1200

## Contact information

- **Practice address:** 13810 CHAMPION FOREST DR STE 204, HOUSTON, TX 77069-1868
- **Practice address phone:** (281) 440-1200
- **Practice address fax:** (281) 440-3578
- **Mailing address:** PO BOX 11470, SPRING, TX 77391-1470
- **Mailing address phone:** (281) 440-1200
- **Mailing address fax:** (281) 440-3578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2019
- **Last updated:** 04/29/2019