Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 33781 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 33781 | TX |
NPI | 1053756635 |
---|---|
Provider Name | Dr. Tamir Dean Anver |
First Address | Birmingham, AL 35249 |
Second Address | Flower Mound, TX 75028-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2013 |
Last Update Date | 09/05/2020 |