Provider Demographics
NPI: | 1790083756 |
---|---|
Name: | TEXAS FAMILY DENTAL CARE |
Entity Type: | Organization |
Organization Name: | TEXAS FAMILY DENTAL CARE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DENTIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SAEED |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AHMADI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 713-943-9993 |
Mailing Address - Street 1: | 2515 STRAWBERRY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PASADENA |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77502-5101 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-943-9993 |
Mailing Address - Fax: | 713-943-9985 |
Practice Address - Street 1: | 2515 STRAWBERRY RD |
Practice Address - Street 2: | |
Practice Address - City: | PASADENA |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77502-5101 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-943-9993 |
Practice Address - Fax: | 713-943-9985 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-03-01 |
Last Update Date: | 2011-03-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 19494 | 1223D0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1223D0001X | Dental Providers | Dentist | Dental Public Health | Group - Multi-Specialty |