MEDICARE: DR. AKBAR AGHA EBRAHIMIAN D.D.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
1	1223G0001X	General Practice Dentistry	18922	TX

General Provider Information

NPI Number	:	1528176922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKBAR AGHA EBRAHIMIAN D.D.S.

Provider Business Mailing Address
First Line	:	4838 HILLSWICK DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3929
Country	:	US
Telephone Number	:	281-242-3547
Fax Number	:

Provider Business Practice Location Address
First Line	:	5814 NEW TERRITORY BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5948
Country	:	US
Telephone Number	:	281-277-8787
Fax Number	:	281-277-8788

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

Provider Enumeration Date	:	08/26/2006
Last Update Date	:	07/08/2007

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