Healthcare Provider Details

I. General information

NPI: 1659935930
Provider Name (Legal Business Name): BADI MISAQI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15500 W STATE HIGHWAY 71 STE 300
BEE CAVE TX
78738-2819
US

IV. Provider business mailing address

929 WESTCOTT ST APT 932
HOUSTON TX
77007-4841
US

V. Phone/Fax

Practice location:
  • Phone: 832-380-0512
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number34906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: