Provider Demographics
NPI:1679729941
Name:KHABBAZ, YASSER (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:YASSER
Middle Name:
Last Name:KHABBAZ
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 BROADWAY ST APT 382
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7815
Mailing Address - Country:US
Mailing Address - Phone:937-554-6765
Mailing Address - Fax:
Practice Address - Street 1:3222 HILLCROFT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5806
Practice Address - Country:US
Practice Address - Phone:713-263-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics