=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073545992
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZEB FERDINAN POINDEXTER D.D.S
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7703 CULLEN BLVD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77051-1905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-734-7611
-----------------------------------------------------
Fax | 713-731-1766
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7703 CULLEN BLVD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-734-7611
-----------------------------------------------------
Fax | 713-731-1766
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 14351
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------