Healthcare Provider Details

I. General information

NPI: 1811773963
Provider Name (Legal Business Name): REHAM SALBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10123 LOUETTA RD STE 900
HOUSTON TX
77070-2190
US

IV. Provider business mailing address

2536 AMHERST ST STE A
HOUSTON TX
77005-3207
US

V. Phone/Fax

Practice location:
  • Phone: 832-843-6776
  • Fax: 832-843-6775
Mailing address:
  • Phone: 713-490-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number39976
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: