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General NPI Number Information
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NPI Number | 1528457629
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS ORAL HEALTH PLLC
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 5625 EIGER RD SUITE 135
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City | AUSTIN
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State | TX
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Zip | 78735-8977
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Country | US
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Telephone | 512-386-1229
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Fax | 512-394-5966
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Provider Business Mailing Address
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Address Line | 5625 EIGER RD SUITE 135
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City | AUSTIN
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State | TX
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Zip | 78735-8977
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Country | US
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Telephone | 512-386-1229
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Fax | 512-394-5966
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. NAZIM K SHAHI
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Credential | DMD
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Telephone | 512-797-6321
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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 | 24968
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License Number State | TX
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