Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 27140 | TX |
Y | 1223P0221X | Pediatric Dentist | 27140 | TX |
NPI | 1013204254 |
---|---|
Provider Name | Dr. Stephanie J Aramwattananont |
First Address | Houston, TX 77034-4496 |
Second Address | Houston, TX 77034-4496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2011 |
Last Update Date | 14/06/2021 |