Individual provider Active NPI

Omar Harmouche, DMD, MPH

  • Dentist
  • Tulia, TX
National Provider Identifier
1336715861
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39163 Issued in TX
Practice address
229 N Maxwell Ave
Tulia, TX 79088-2250
Phone
(806) 995-4191
NPI assigned
Jun 3, 2021
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39163 TX Primary
General Practice Dentistry 1223G0001X 10629 KY

Addresses

Primary practice location

229 N Maxwell Ave
Tulia, TX 79088-2250

Mailing address

5183 Hinkleville Rd
Paducah, KY 42001-9667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39163TXMDDentist
10629KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Omar Harmouche PLLC CurrentSince Jan 22, 2023 Accepting new patients
David J, Elrod, DMD. a Professional Service Corporation General Practice PastSince Jun 1, 2021 Accepting new patients

Locations

229 N Maxwell Ave
Tulia, TX 79088
Phone (806) 995-4191

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1336715861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5183 HINKLEVILLE RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N MAXWELL AVE",
            "city": "TULIA",
            "state": "TX",
            "postal_code": "790882250",
            "telephone_number": "806-995-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMOUCHE",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39163",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.