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General NPI Number Information
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NPI Number | 1356864870
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Entity Type | Individual
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Provider Name | EMAD ABDALLAH
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Gender | Male
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 07/30/2023
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Provider Practice Location Address
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Address Line | 2311 HARRY WURZBACH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78209-5543
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Country | US
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Telephone | 210-824-3531
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Fax | 210-824-0068
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Provider Business Mailing Address
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Address Line | 1347 BURNING ARROW
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City | SAN ANTONIO
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State | TX
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Zip | 78258-2765
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Country | US
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Telephone | 617-319-1050
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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 | 2901022392
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License Number State | MI
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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 | 38276
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License Number State | TX
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