Provider Demographics
NPI:1881000347
Name:TAHA, NAWAR
Entity Type:Individual
Prefix:MS
First Name:NAWAR
Middle Name:
Last Name:TAHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 WALNUT BEND LN
Mailing Address - Street 2:APARTMENT 1014
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4805
Mailing Address - Country:US
Mailing Address - Phone:832-359-0620
Mailing Address - Fax:
Practice Address - Street 1:12800 FOUNTAIN LAKE CIR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3756
Practice Address - Country:US
Practice Address - Phone:281-277-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice