Provider Demographics
NPI:1164810172
Name:MAVELI, THOMAS CHARLIE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHARLIE
Last Name:MAVELI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9526 N SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE # 3116
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4733
Mailing Address - Country:US
Mailing Address - Phone:832-361-3222
Mailing Address - Fax:
Practice Address - Street 1:5406 AIRLINE DR UNIT F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-4949
Practice Address - Country:US
Practice Address - Phone:713-800-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-27
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX295341223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice