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General NPI Number Information
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NPI Number | 1033810460
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Entity Type | Individual
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Provider Name | NADER SAMIR MEKHAEL
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Gender | Male
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1705 N TOWN EAST BLVD STE 100
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City | MESQUITE
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State | TX
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Zip | 75150-4140
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Country | US
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Telephone | 214-210-2327
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Fax |
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Provider Business Mailing Address
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Address Line | 6206 DUCK CREEK DR APT 7206
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City | GARLAND
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State | TX
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Zip | 75043-7839
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Country | US
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Telephone | 714-369-7185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41085
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13337
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41085
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License Number State | TX
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