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General NPI Number Information
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NPI Number | 1013205715
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Entity Type | Organization
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Legal Business Name | PAYMON PAHLAVAN, DDS, PA
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 10815 VETERANS MEMORIAL DR SUITE 1000
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City | HOUSTON
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State | TX
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Zip | 77067-3845
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Country | US
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Telephone | 281-850-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 8502 WYNDHAM CT
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City | JERSEY VILLAGE
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State | TX
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Zip | 77040-1138
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Country | US
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Telephone | 281-850-2900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAYMON PAHLAVAN
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Credential | D.D.S.
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Telephone | 281-850-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24039
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License Number State | TX
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