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General NPI Number Information
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NPI Number | 1689194847
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Entity Type | Individual
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Provider Name | ZEENAT ABDULALI KHERALUWALA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 06/20/2017
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Provider Practice Location Address
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Address Line | 325 ADAMS DR STE 335
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City | WEATHERFORD
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State | TX
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Zip | 76086-6742
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Country | US
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Telephone | 682-803-2003
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 BUSHNELL DR APT 733
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City | FORT WORTH
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State | TX
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Zip | 76116-5830
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Country | US
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Telephone | 469-230-4839
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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 | 32933
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License Number State | TX
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