Provider Demographics
NPI:1952612509
Name:DAVOODY, AMIRPARVIZ RIAZ (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:AMIRPARVIZ
Middle Name:RIAZ
Last Name:DAVOODY
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 BELLAIRE BLVD
Mailing Address - Street 2:SUITE# B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1121
Mailing Address - Country:US
Mailing Address - Phone:713-662-0621
Mailing Address - Fax:
Practice Address - Street 1:4061 BELLAIRE BLVD
Practice Address - Street 2:SUITE# B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1121
Practice Address - Country:US
Practice Address - Phone:713-662-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0099971223X0400X
TX00259371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics