Provider Demographics
NPI:1083874499
Name:CHOUDHURY, ERIC SANJAY (DMD, MDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SANJAY
Last Name:CHOUDHURY
Suffix:
Gender:M
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 RICHMOND AVE STE 149
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4647
Mailing Address - Country:US
Mailing Address - Phone:713-771-9308
Mailing Address - Fax:
Practice Address - Street 1:9700 RICHMOND AVE STE 149
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4647
Practice Address - Country:US
Practice Address - Phone:713-771-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist