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General NPI Number Information
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NPI Number | 1881367415
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Entity Type | Organization
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Legal Business Name | EVOLUTION DENTISTRY
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 50 BRIAR HOLLOW LN STE 125W
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City | HOUSTON
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State | TX
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Zip | 77027-9362
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Country | US
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Telephone | 713-647-8000
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Fax | 346-980-5522
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Provider Business Mailing Address
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Address Line | 50 BRIAR HOLLOW LN STE 125W
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City | HOUSTON
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State | TX
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Zip | 77027-9362
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Country | US
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Telephone | 713-647-8000
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Fax | 346-980-5522
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMAD ABDUL EL-KHEIR
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Credential | D.D.S.
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Telephone | 713-647-8000
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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