Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 13462 | TX |
NPI | 1134241813 |
---|---|
Provider Name | Dr. Tsadik Dico Hassid |
First Address | Houston, TX 77074-4335 |
Second Address | Houston, TX 77074-4335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |