Provider Demographics
NPI:1578620878
Name:AMERI, MASH
Entity Type:Individual
Prefix:
First Name:MASH
Middle Name:
Last Name:AMERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13551 WILL CLAYTON PKWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3758
Mailing Address - Country:US
Mailing Address - Phone:281-812-1122
Mailing Address - Fax:
Practice Address - Street 1:13551 WILL CLAYTON PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3758
Practice Address - Country:US
Practice Address - Phone:281-812-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice