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General NPI Number Information
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NPI Number | 1336394873
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Entity Type | Individual
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Provider Name | ISLAM ABDELHADY KHASAWNEH DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 12335 HYMEADOW DR STE 250
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City | AUSTIN
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State | TX
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Zip | 78750-1934
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Country | US
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Telephone | 512-250-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 13730 FM 620 APT 427
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City | AUSTIN
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State | TX
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Zip | 78717-1034
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Country | US
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Telephone | 443-889-3147
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24287
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 24287
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License Number State | TX
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