Provider Demographics
NPI:1629010657
Name:MAGZEN, THOMAS HARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HARRY
Last Name:MAGZEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 FONDREN RD
Mailing Address - Street 2:SUITE B-105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5513
Mailing Address - Country:US
Mailing Address - Phone:713-981-9513
Mailing Address - Fax:
Practice Address - Street 1:11000 FONDREN RD
Practice Address - Street 2:SUITE B-105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5513
Practice Address - Country:US
Practice Address - Phone:713-981-9513
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice