Healthcare Provider Details

I. General information

NPI: 1750067724
Provider Name (Legal Business Name): TEHAUM SAOOD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8465 MEMORIAL BLVD STE 100
PORT ARTHUR TX
77640
US

IV. Provider business mailing address

8306 WHITE WILLOW LANE
BAYTOWN TX
77523
US

V. Phone/Fax

Practice location:
  • Phone: 409-853-3107
  • Fax:
Mailing address:
  • Phone: 713-551-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39697
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: