Provider Demographics
NPI:1902510779
Name:FLASH DENTAL BRAESWOOD
Entity Type:Organization
Organization Name:FLASH DENTAL BRAESWOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICER, HR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:AABA
Authorized Official - Phone:713-677-9983
Mailing Address - Street 1:9099 KATY FWY STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1632
Mailing Address - Country:US
Mailing Address - Phone:713-465-1860
Mailing Address - Fax:
Practice Address - Street 1:4004 S BRAESWOOD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3304
Practice Address - Country:US
Practice Address - Phone:713-465-1860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental