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General NPI Number Information
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NPI Number | 1912253428
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Entity Type | Individual
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Provider Name | FABIA YOUNUS BDS, MSD, MS
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Gender | Female
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 2154 BANCROFT ST
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City | HOUSTON
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State | TX
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Zip | 77027-3704
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Country | US
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Telephone | 201-294-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 665 S SKINKER BLVD APT 9A
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City | SAINT LOUIS
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State | MO
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Zip | 63105-2347
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Country | US
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Telephone | 201-294-7408
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 32686
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 32686
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License Number State | TX
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