Provider Demographics
NPI:1275960023
Name:HAIDER, ZANE K (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:ZANE
Middle Name:K
Last Name:HAIDER
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 FM 2920 RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3672
Mailing Address - Country:US
Mailing Address - Phone:281-937-2540
Mailing Address - Fax:
Practice Address - Street 1:2540 FM 2920 RD
Practice Address - Street 2:SUITE H
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3672
Practice Address - Country:US
Practice Address - Phone:281-937-2540
Practice Address - Fax:281-709-6110
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3635096Medicaid