Provider Demographics
NPI:1780847301
Name:PAHLAVAN, PAYMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAYMON
Middle Name:
Last Name:PAHLAVAN
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 1:10815 VETERANS MEMORIAL DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3845
Mailing Address - Country:US
Mailing Address - Phone:281-529-6266
Mailing Address - Fax:281-529-6267
Practice Address - Street 1:10815 VETERANS MEMORIAL DR STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3845
Practice Address - Country:US
Practice Address - Phone:281-529-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102246122300000X
TX24039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist