Provider Demographics
NPI:1992044424
Name:ELATHAMNA, EIAD NEHAD
Entity Type:Individual
Prefix:DR
First Name:EIAD
Middle Name:NEHAD
Last Name:ELATHAMNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON
Mailing Address - Street 2:7500 CAMBRIDGE STREET , SUITE 5452
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054
Mailing Address - Country:US
Mailing Address - Phone:713-486-4471
Mailing Address - Fax:713-486-4353
Practice Address - Street 1:SCHOOL OF DENTISTRY
Practice Address - Street 2:7500 CAMBRIDGE ST , SUITE 5452
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-486-4471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9260122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist