Healthcare Provider Details

I. General information

NPI: 1740721356
Provider Name (Legal Business Name): BPM ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N BROOKS ST
BRAZORIA TX
77422-8718
US

IV. Provider business mailing address

PO BOX 1235
BRAZORIA TX
77422-1235
US

V. Phone/Fax

Practice location:
  • Phone: 979-798-9103
  • Fax: 979-798-9109
Mailing address:
  • Phone: 979-798-9103
  • Fax: 979-798-9109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10723
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10723
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number10723
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number10723
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10723
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number10723
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number10723
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number10723
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number10723
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code125J00000X
TaxonomyDental Therapist
License Number10723
License Number StateTX
# 11
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number10723
License Number StateTX
# 12
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number10723
License Number StateTX
# 13
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10723
License Number StateTX

VIII. Authorized Official

Name: MR. CARY ZOLMAN
Title or Position: CFO
Credential:
Phone: 979-798-9103