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General NPI Number Information
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NPI Number | 1780968362
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Entity Type | Organization
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Legal Business Name | KZSS TEXAS CAPITAL DENTAL LTD, LLP
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 1015 E BRAKER LN STE 2-3
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City | AUSTIN
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State | TX
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Zip | 78753-3449
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Country | US
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Telephone | 512-832-1121
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Fax | 877-833-4825
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Provider Business Mailing Address
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Address Line | 1015 E BRAKER LN STE 2-3
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City | AUSTIN
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State | TX
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Zip | 78753-3449
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Country | US
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Telephone | 512-832-1121
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Fax | 877-833-4825
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FAKERI ZAYED
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Credential | DDS
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Telephone | 512-569-0274
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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 | 22714
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License Number State | TX
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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 | 21278
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License Number State | TX
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