Organization
JEAN C STOUT DDS AND ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEARL OLLYNE LAVERNE (OFFICE MANAGER)
(713) 947-8228
Entity
Organization
Contact information
Practice address
2907 STRAWBERRY RD, PASADENA, TX 77502-5214
(713) 947-8222
Mailing address
2907 STRAWBERRY RD, PASADENA, TX 77502-5214
(713) 947-8222
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090507701
—
TX
Enumeration date
03/19/2014
Last updated
03/19/2014
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