Provider Demographics
NPI:1881051654
Name:GHOLAM R. ZAKHIREH, DMD
Entity type:Organization
Organization Name:GHOLAM R. ZAKHIREH, DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHOLAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZAKHIREH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-338-7700
Mailing Address - Street 1:1602 W BAKER RD STE B
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2282
Mailing Address - Country:US
Mailing Address - Phone:281-838-8433
Mailing Address - Fax:281-838-8552
Practice Address - Street 1:1602 W BAKER RD STE B
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2282
Practice Address - Country:US
Practice Address - Phone:281-838-8433
Practice Address - Fax:281-838-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty