Provider Demographics
NPI:1720207939
Name:UPTOWN GENERAL & COSMETIC
Entity Type:Organization
Organization Name:UPTOWN GENERAL & COSMETIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-355-5555
Mailing Address - Street 1:5373 W ALABAMA ST STE 118
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-5939
Mailing Address - Country:US
Mailing Address - Phone:713-355-5555
Mailing Address - Fax:713-355-5557
Practice Address - Street 1:5373 W ALABAMA ST STE 118
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5939
Practice Address - Country:US
Practice Address - Phone:713-355-5555
Practice Address - Fax:713-355-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty