Provider Demographics
NPI:1497139711
Name:ELMAJIE, TAREK (BDS,MSD,CAGS)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:ELMAJIE
Suffix:
Gender:M
Credentials:BDS,MSD,CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 US HIGHWAY 259 S
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654-3629
Mailing Address - Country:US
Mailing Address - Phone:903-392-8203
Mailing Address - Fax:
Practice Address - Street 1:1115 US HIGHWAY 259 S
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654-3629
Practice Address - Country:US
Practice Address - Phone:903-392-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX324241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice