Provider Demographics
NPI:1649380692
Name:RABILE, HODAN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:HODAN
Middle Name:M
Last Name:RABILE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 N MACARTHUR BLVD
Mailing Address - Street 2:#150
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038
Mailing Address - Country:US
Mailing Address - Phone:972-756-9557
Mailing Address - Fax:972-756-9558
Practice Address - Street 1:5330 N MACARTHUR BLVD
Practice Address - Street 2:#150
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:972-756-9557
Practice Address - Fax:972-756-9558
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20835122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168746901Medicaid