MEDICARE: SERGE BOU MECHREK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	36816	TX
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	36816	TX

General Provider Information

NPI Number	:	1366059388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERGE BOU MECHREK

Provider Business Mailing Address
First Line	:	1502 S WESTMORELAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-5765
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 S WESTMORELAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-5765
Country	:	US
Telephone Number	:	214-550-7137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2020
Last Update Date	:	02/10/2026

Similar Medicare Providers

1275312068 — COSMIC DENTAL PLLC
Practice Location Address:

1502 S WESTMORELAND RD
DALLAS, TX
75211-5765

Practice Phone: 904-729-2866
Practice Fax:

1558568824 — ESSILOR LABORATORIES OF AMERICA, L.P.
Practice Location Address:

13515 N STEMMONS FWY
DALLAS, TX
75234-5765

Practice Phone: 800-843-3937
Practice Fax:

1861699126 — ESSILOR LABORATORIES OF AMERICA CALIFORNIA ACQUISITION CORPORATION
Practice Location Address:

13515 N STEMMONS FWY
DALLAS, TX
75234-5765

Practice Phone: 800-843-3937
Practice Fax:

1700084209 — ESSILOR LABORATORIES OF AMERICA, L.P.
Practice Location Address:

13515 N. STEMMONS FREEWAY
DALLAS, TX
75234-5765

Practice Phone: 800-366-6342
Practice Fax:

1588985477 — ESSILOR VISION FOUNDATION
Practice Location Address:

13515 N STEMMONS FWY
DALLAS, TX
75234-5765

Practice Phone: 972-764-1280
Practice Fax:

1124335294 — THEA JEAN JORDAN O.D.
Practice Location Address:

13515 N STEMMONS FWY
DALLAS, TX
75234-5765

Practice Phone: 678-358-8826
Practice Fax:

Directions to “ SERGE BOU MECHREK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.