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NPI Code Detail

MEDICARE: NADA AMR FAWZI DDS

MEDICARE: NADA AMR FAWZI DDS
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
11223G0001XGeneral Practice Dentistry40489TX

General Provider Information

NPI Number : 1174367841
Entity Type Code : Individual
Provider Name (Legal Business Name) : NADA AMR FAWZI DDS
Provider Business Mailing Address
First Line : 421 W 3RD ST APT 601
Second Line :
City : AUSTIN
State : TX
Zip : 78701-4164
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 715 OLD AUSTIN HWY STE 400
Second Line :
City : BASTROP
State : TX
Zip : 78602-5165
Country : US
Telephone Number : 512-212-9803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2024
Last Update Date : 07/01/2024

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Directions to “ NADA AMR FAWZI DDS” Practice Location

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