Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 19594 | TX |
NPI | 1073628772 |
---|---|
Provider Name | Dr. Hamid Atabakhsh |
First Address | Spring, TX 77388-4785 |
Second Address | Spring, TX 77388-4785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 03/10/2014 |