Active NPI
Cory James Logan, D.D.S.
- General Practice Dentistry
- Houston, TX
National Provider Identifier
1265529226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19464
- Practice address
- 530 Waugh Dr
Houston, TX 77019-2002 - Phone
- (713) 942-8598
- Fax
- (713) 942-8591
- NPI assigned
- Oct 9, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19464 | TX | Primary |
Addresses
Primary practice location
530 Waugh Dr
Houston, TX 77019-2002
Mailing address
6633 Teluco St
Houston, TX 77055-5359
Phone (713) 290-0331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19464 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Well Houston LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Customized Equipment (DME)
- Houston, TX
- NPI 1629625553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265529226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6633 TELUCO ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770555359",
"telephone_number": "713-290-0331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 WAUGH DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770192002",
"telephone_number": "713-942-8598",
"fax_number": "713-942-8591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "CORY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.