Individual
MR. ANTHONY MEDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
16418 CANYON CHASE DR, HOUSTON, TX 77095-6532
(832) 428-7616
Mailing address
16418 CANYON CHASE DR, HOUSTON, TX 77095-6532
(832) 428-7616
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
15347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16899832
DRIVER'S LICENSE
TX
Enumeration date
06/13/2014
Last updated
06/13/2014
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