Provider Demographics
NPI:1134114564
Name:DRS PAHLAVAN & NGUYEN PA
Entity Type:Organization
Organization Name:DRS PAHLAVAN & NGUYEN PA
Other - Org Name:LITTLE YORK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:POORANG
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHLAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-447-7220
Mailing Address - Street 1:410 W LITTLE YORK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1305
Mailing Address - Country:US
Mailing Address - Phone:281-447-7220
Mailing Address - Fax:281-447-7221
Practice Address - Street 1:410 W LITTLE YORK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1305
Practice Address - Country:US
Practice Address - Phone:281-447-7220
Practice Address - Fax:281-447-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty