Provider Demographics
NPI:1184028060
Name:GREENWAY ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:GREENWAY ORTHODONTICS PLLC
Other - Org Name:GREATER HOUSTON ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIRPARVIZ
Authorized Official - Middle Name:RIAZ
Authorized Official - Last Name:DAVOODY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:713-662-0621
Mailing Address - Street 1:9412 GAYLORD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3034
Mailing Address - Country:US
Mailing Address - Phone:713-662-0621
Mailing Address - Fax:
Practice Address - Street 1:9412 GAYLORD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3034
Practice Address - Country:US
Practice Address - Phone:713-662-0621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX259371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty