Provider Demographics
NPI:1124380910
Name:URBACH, ALAN LEWIS
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:LEWIS
Last Name:URBACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 PAISLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4128
Mailing Address - Country:US
Mailing Address - Phone:713-292-6828
Mailing Address - Fax:
Practice Address - Street 1:4101 GREENBRIAR ST
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5294
Practice Address - Country:US
Practice Address - Phone:713-292-6828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX296761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry