MEDICARE: DR. FARHAD ZONOOZI DMD

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
1	122300000X	Dentist	DS041332	PA
2	122300000X	Dentist	37580	TX
3	1223G0001X	General Practice Dentistry	37580	PA

General Provider Information

NPI Number	:	1205377355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARHAD ZONOOZI DMD

Provider Business Mailing Address
First Line	:	8420 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2004
Country	:	US
Telephone Number	:	281-855-8444
Fax Number	:

Provider Business Practice Location Address
First Line	:	8420 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2004
Country	:	US
Telephone Number	:	281-855-8444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2017
Last Update Date	:	07/01/2024

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