Pearsall Dental PLLC-PA
Organization Active NPI Dentist · Pearsall, TX
NPI 1194134577 · NPPES record last updated Aug 11, 2014
Key facts
- NPI
- 1194134577
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 26095 (TX)
- Legal business name
- PEARSALL DENTAL PLLC-PA
- Practice address
- 1809 Louise Lane
Suite 200
Pearsall, TX 78061-3215 - Phone
- (210) 846-5571
- NPI assigned
- Aug 11, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Bassam Abdulnaim Abazid, D.D.S.
- Title
- Owner
- Phone
- (210) 846-5571
National Provider Directory
Locations
1809 Louise Ln
Ste 200
Pearsall, TX 78061
Phone (210) 846-5571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 26095 | TX | Yes |
Addresses
Primary practice location
1809 Louise Lane
Suite 200
Pearsall, TX 78061-3215
Mailing address
1809 Louise Lane
Suite 200
Pearsall, TX 78061-3207
Phone (210) 846-5571
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218209907 | Medicaid | TX |
Other names
- DDS Dental
Other providers in Pearsall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.