Provider Demographics
NPI:1255772778
Name:AHMAD, WALEED KHALED (DDS)
Entity type:Individual
Prefix:DR
First Name:WALEED
Middle Name:KHALED
Last Name:AHMAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WALEED
Other - Middle Name:KH
Other - Last Name:ZUBAIDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:117 SOUTHPOINT LANE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351
Mailing Address - Country:US
Mailing Address - Phone:936-327-9490
Mailing Address - Fax:
Practice Address - Street 1:117 SOUTHPOINT LANE
Practice Address - Street 2:SUITE 400
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351
Practice Address - Country:US
Practice Address - Phone:936-327-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29301122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist