Provider Demographics
NPI:1538614185
Name:ROBERT FREELE DDS
Entity type:Organization
Organization Name:ROBERT FREELE DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:FREELE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-430-4845
Mailing Address - Street 1:1202 CHELSHURST WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3247
Mailing Address - Country:US
Mailing Address - Phone:281-430-4845
Mailing Address - Fax:281-430-4844
Practice Address - Street 1:1202 CHELSHURST WAY
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3247
Practice Address - Country:US
Practice Address - Phone:281-430-4845
Practice Address - Fax:281-430-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9587261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental