Provider Demographics
NPI:1801972849
Name:HUQUE, MEHERUN NESSA (DDS)
Entity type:Individual
Prefix:DR
First Name:MEHERUN
Middle Name:NESSA
Last Name:HUQUE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MEHERUN
Other - Middle Name:NESSA
Other - Last Name:HUQUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2019 SHAVER ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-3635
Mailing Address - Country:US
Mailing Address - Phone:713-477-2900
Mailing Address - Fax:713-477-2995
Practice Address - Street 1:2019 SHAVER ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-3635
Practice Address - Country:US
Practice Address - Phone:713-477-2900
Practice Address - Fax:713-477-2995
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX164291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111029804Medicaid