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Organization

UTHHSC-PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY R BADGER DDS, MS (CHAIR)
(713) 486-4141
Entity
Organization

Contact information

Practice address
7500 CAMBRIDGE ST, SUITE 5301, HOUSTON, TX 77054-2032
(713) 486-4141
(713) 486-4179
Mailing address
7500 CAMBRIDGE ST, SUITE 5301, HOUSTON, TX 77054-2032
(713) 486-4141
(713) 486-4179

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009733901
TX
Enumeration date
09/22/2015
Last updated
09/22/2015
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