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NPI Code Detail

MEDICARE: DR. HAMID ATABAKHSH D.D.S., M.S.

MEDICARE: DR. HAMID ATABAKHSH D.D.S., M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodontics19594TX

General Provider Information

NPI Number : 1073628772
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAMID ATABAKHSH D.D.S., M.S.
Provider Business Mailing Address
First Line : 2525 LOUETTA RD STE 101
Second Line :
City : SPRING
State : TX
Zip : 77388-4785
Country : US
Telephone Number : 281-288-7140
Fax Number : 281-288-4924
Provider Business Practice Location Address
First Line : 2525 LOUETTA RD STE 101
Second Line :
City : SPRING
State : TX
Zip : 77388-4785
Country : US
Telephone Number : 281-288-7140
Fax Number : 281-288-4924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 10/03/2014

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