=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992045371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H AND H YAMANI LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2013
-----------------------------------------------------
Last Update Date | 02/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23607 KELLY JOE SMITH ROAD SUITE D
-----------------------------------------------------
City | PORTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77365-8405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-760-8630
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10990 WEST RD APARTMENT NUMBER 601
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77064-8812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-760-8630
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. MUSTAFA QMARUDDIN YAMANI
-----------------------------------------------------
Credential | D.D.S, M.S
-----------------------------------------------------
Telephone | 832-760-8630
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 22455
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------