MEDICARE: FADY GUIRGUIS DDS PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1538981477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FADY GUIRGUIS DDS PLLC

Provider Business Mailing Address
First Line	:	3319 CENTRAL GARDEN LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5398
Country	:	US
Telephone Number	:	917-602-3213
Fax Number	:

Provider Business Practice Location Address
First Line	:	3319 CENTRAL GARDEN LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5398
Country	:	US
Telephone Number	:	917-602-3213
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/CEO
Name	:	FADY N. GUIRGUIS
Credential	:	DDS
Telephone Number	:	917-602-3213

Provider Enumeration Date	:	10/31/2024
Last Update Date	:	10/31/2024

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