Sd Texarkana
Dentist, General Practice in Texarkana, TX. Organization (NPI-2).
NPI number1982246690
StatusActive
Last updated in NPPESOct 14, 2019
Details
- NPI
- 1982246690
- Entity type
- Organization (NPI-2)
- Legal business name
- Sd Texarkana
- Organization subpart
- No
- Enumeration date
- Oct 14, 2019
- Last updated
- Oct 14, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Sd Texarkana, PLLC (Doing Business As)
Practice location
3225 Kennedy LnTexarkana, TX 75503-2428
Phone 903-306-2384 · Fax 903-306-2459
Mailing address
Po Box 450758Garland, TX 75045-0758
Phone 214-466-1400 · Fax 214-367-5896
Authorized official
Lynhthy T Pham
Owner
2144661400
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