Healthcare Provider Details

I. General information

NPI: 1447571138
Provider Name (Legal Business Name): SEPIDEH SAHAR CARVOUNIS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10123 LOUETTA RD STE 900
HOUSTON TX
77070-2161
US

IV. Provider business mailing address

10123 LOUETTA RD STE 900
HOUSTON TX
77070-2161
US

V. Phone/Fax

Practice location:
  • Phone: 832-843-6776
  • Fax:
Mailing address:
  • Phone: 832-843-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0025615
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: