Provider Demographics
NPI:1689683963
Name:THUC M LA DDS PA
Entity type:Organization
Organization Name:THUC M LA DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUC
Authorized Official - Middle Name:M
Authorized Official - Last Name:LA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-568-8200
Mailing Address - Street 1:11201 BELLAIRE BLVD
Mailing Address - Street 2:STE# A-18
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2544
Mailing Address - Country:US
Mailing Address - Phone:281-568-8200
Mailing Address - Fax:281-568-8884
Practice Address - Street 1:11201 BELLAIRE BLVD
Practice Address - Street 2:STE# A-18
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2544
Practice Address - Country:US
Practice Address - Phone:281-568-8200
Practice Address - Fax:281-568-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty