MEDICARE: DR. MICHEL AZER REFAAT DDS, MSD

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	1223P0300X	Periodontics	DL12622	MA
2	1223P0300X	Periodontics	33843	TX

General Provider Information

NPI Number	:	1952773590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHEL AZER REFAAT DDS, MSD

Provider Business Mailing Address
First Line	:	1811 BERING DR STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3186
Country	:	US
Telephone Number	:	909-614-3693
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 BERING DR STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3186
Country	:	US
Telephone Number	:	909-614-3693
Fax Number	:

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

Provider Enumeration Date	:	10/22/2015
Last Update Date	:	03/07/2023

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