=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871823435
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABRAM FAMILY DENTAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2010
-----------------------------------------------------
Last Update Date | 09/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 E ABRAM ST STE 100
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76010-7252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-635-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 E ABRAM ST STE 100
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76010-7252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-635-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RICHARD W TOWNSLEY III
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 817-635-1900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 23271
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------