Organization
UTHHSC-PEDIATRIC DENTISTRY
Active
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
Update your record
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