Healthcare Provider Details

I. General information

NPI: 1174200596
Provider Name (Legal Business Name): NUSHRAH ELAHI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24522 KINGSLAND BLVD
KATY TX
77494-3429
US

IV. Provider business mailing address

29620 FULSHEAR LAKE TRCE
RICHMOND TX
77406-3314
US

V. Phone/Fax

Practice location:
  • Phone: 713-344-0498
  • Fax:
Mailing address:
  • Phone: 832-574-7794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: