Provider Demographics
NPI:1932655388
Name:AHMAD MILLWALA OMFS PLLC
Entity Type:Organization
Organization Name:AHMAD MILLWALA OMFS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:773-732-8288
Mailing Address - Street 1:16226 PINON VISTA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-7196
Mailing Address - Country:US
Mailing Address - Phone:773-732-8288
Mailing Address - Fax:281-781-2552
Practice Address - Street 1:16226 PINON VISTA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-7196
Practice Address - Country:US
Practice Address - Phone:773-732-8288
Practice Address - Fax:281-781-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty