Provider Demographics
NPI:1891343232
Name:OBEIDAT, HALAH (DMD)
Entity Type:Individual
Prefix:
First Name:HALAH
Middle Name:
Last Name:OBEIDAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 E DOVE AVE APT 404
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3986
Mailing Address - Country:US
Mailing Address - Phone:440-570-0795
Mailing Address - Fax:
Practice Address - Street 1:4502 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9739
Practice Address - Country:US
Practice Address - Phone:956-800-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX356731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice