Provider Demographics
NPI:1497005698
Name:AUSTAH, OBADAH NABEEL (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:OBADAH
Middle Name:NABEEL
Last Name:AUSTAH
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 ROWLEY RD
Mailing Address - Street 2:5104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4819
Mailing Address - Country:US
Mailing Address - Phone:571-234-0211
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:DENTAL SCHOOL MSC - 7892
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN421223E0200X
TX306721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics