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General NPI Number Information
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NPI Number | 1376767004
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Entity Type | Individual
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Provider Name | NAGY B GHATTAS D.D.S
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 3403 RIVERS EDGE TRL
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City | KINGWOOD
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State | TX
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Zip | 77339-2634
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Country | US
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Telephone | 281-973-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 13830 WINDWARD HARBOR CT
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City | HOUSTON
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State | TX
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Zip | 77059-5013
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Country | US
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Telephone | 713-440-8488
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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 | 18028
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18028
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License Number State | TX
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