Provider Demographics
NPI:1649881491
Name:CHAUDHRY, USMAN (DMD, MPH, MS)
Entity type:Individual
Prefix:DR
First Name:USMAN
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:DMD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 WIMBERLY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6668
Mailing Address - Country:US
Mailing Address - Phone:571-490-5915
Mailing Address - Fax:
Practice Address - Street 1:6480 EASTEX FWY STE A
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-4336
Practice Address - Country:US
Practice Address - Phone:409-241-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist