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Organization
PEARSALL DENTAL PLLC-PA
Active
Organization
PEARSALL DENTAL PLLC-PA
Active
Other names
DDS Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASSAM ABDULNAIM ABAZID D.D.S. (OWNER)
(210) 846-5571
Entity
Organization
Contact information
Practice address
1809 LOUISE LANE, SUITE 200, PEARSALL, TX 78061-3215
(210) 846-5571
Mailing address
1809 LOUISE LANE, SUITE 200, PEARSALL, TX 78061-3207
(210) 846-5571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218209907
—
TX
Enumeration date
08/11/2014
Last updated
08/11/2014
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