Provider Demographics
NPI:1922239029
Name:ARSIWALA, TASNIM S
Entity Type:Individual
Prefix:DR
First Name:TASNIM
Middle Name:S
Last Name:ARSIWALA
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 1:3600 FM 1488 RD STE 90
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3818
Mailing Address - Country:US
Mailing Address - Phone:936-202-2689
Mailing Address - Fax:
Practice Address - Street 1:3600 FM 1488 RD STE 90
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3818
Practice Address - Country:US
Practice Address - Phone:936-202-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist