Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 23719 | TX |
Y | 1223P0300X | Periodontist | 23719 | TX |
NPI | 1033383765 |
---|---|
Provider Name | Anas Halaweh |
First Address | Houston, TX 77005-3207 |
Second Address | Missouri City, TX 77459-4765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 19/09/2019 |