Individual
CARLOS MEDELLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2302 KEYHOLE LN, HOUSTON, TX 77084-5262
(281) 647-6656
Mailing address
2302 KEYHOLE LN, HOUSTON, TX 77084-5262
(281) 647-6656
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
10/23/2021
Last updated
10/23/2021
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