Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 33405 | TX |
NPI | 1063937613 |
---|---|
Provider Name | Sara Abedini |
First Address | Houston, TX 77005-3207 |
Second Address | Conroe, TX 77304-2333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2017 |
Last Update Date | 26/09/2019 |