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NPI Code Detail

MEDICARE: ISMA KHALID

MEDICARE: ISMA KHALID
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
11223P0221XPediatric Dentistry016.0133977VT
21223P0221XPediatric Dentistry36887TX

General Provider Information

NPI Number : 1265919286
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISMA KHALID
Provider Business Mailing Address
First Line : 36 THOMAS INDIAN SCHOOL DRIVE
Second Line :
City : IRVING
State : NY
Zip : 14081-9300
Country : US
Telephone Number : 716-532-5582
Fax Number : 716-242-6344
Provider Business Practice Location Address
First Line : 6729 AIRLINE DR
Second Line :
City : HOUSTON
State : TX
Zip : 77076-3522
Country : US
Telephone Number : 713-325-5189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 08/17/2021

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Directions to “ ISMA KHALID ” Practice Location

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