Provider Demographics
NPI:1578942538
Name:ELFIKY, OMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:ELFIKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21150 INTERSTATE 35
Mailing Address - Street 2:STE. G
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640
Mailing Address - Country:US
Mailing Address - Phone:512-256-3500
Mailing Address - Fax:512-256-1900
Practice Address - Street 1:21150 INTERSTATE 35
Practice Address - Street 2:STE. G
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:512-256-3500
Practice Address - Fax:512-256-1900
Is Sole Proprietor?:No
Enumeration Date:2015-05-23
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040519122300000X
TX35954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist