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General NPI Number Information
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NPI Number | 1316472434
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Entity Type | Individual
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Provider Name | PRATIKSHA AMIN DMD, MPH
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Gender | Female
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 12110 MURPHY RD STE A
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City | STAFFORD
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State | TX
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Zip | 77477-2407
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Country | US
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Telephone | 281-495-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 12110 MURPHY RD STE A
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City | STAFFORD
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State | TX
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Zip | 77477-2407
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Country | US
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Telephone | 832-689-0328
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS041186
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License Number State | PA
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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 | 35856
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License Number State | TX
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