Individual
AEVA LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
955 COACHLIGHT DR, HOUSTON, TX 77077-1107
(281) 896-3309
Mailing address
955 COACHLIGHT DR, HOUSTON, TX 77077-1107
(281) 896-3309
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27260
TX
1223G0001X
General Practice Dentistry
DE00008410
WA
Other
Enumeration date
03/06/2009
Last updated
08/11/2011
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