Provider Demographics
NPI:1518301662
Name:TEXAS PREMIER DENTAL
Entity Type:Organization
Organization Name:TEXAS PREMIER DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIASGAR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MOGRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-206-0100
Mailing Address - Street 1:13203 FRY RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3693
Mailing Address - Country:US
Mailing Address - Phone:281-206-0100
Mailing Address - Fax:
Practice Address - Street 1:13203 FRY RD STE 500
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3693
Practice Address - Country:US
Practice Address - Phone:281-206-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty