Provider Demographics
NPI:1457418741
Name:NESHAN, NEY
Entity Type:Individual
Prefix:
First Name:NEY
Middle Name:
Last Name:NESHAN
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 1:427 W 20TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2441
Mailing Address - Country:US
Mailing Address - Phone:713-864-1315
Mailing Address - Fax:713-864-7431
Practice Address - Street 1:427 W 20TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2441
Practice Address - Country:US
Practice Address - Phone:713-864-1315
Practice Address - Fax:713-864-7431
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice