Provider Demographics
NPI:1245376805
Name:PHANG, PAUL ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:PHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:20660 WESTHEIMER PKWY STE K
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6300
Mailing Address - Country:US
Mailing Address - Phone:281-579-2600
Mailing Address - Fax:281-579-2624
Practice Address - Street 1:20660 WESTHEIMER PKWY STE K
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6300
Practice Address - Country:US
Practice Address - Phone:281-579-2600
Practice Address - Fax:281-579-2624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics