# FATEMEH EBRAHIMI DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508260894
- **Authorized official:** DR. FADI TATARI DDS (CLINICAL DIRECTOR)
- **Authorized official phone:** (832) 444-9055

## Contact information

- **Practice address:** 6430 RICHMOND AVE STE 110, HOUSTON, TX 77057-5908
- **Practice address phone:** (713) 779-2273
- **Mailing address:** 7521 SOUTHWEST FWY, HOUSTON, TX 77074-1903
- **Mailing address phone:** (713) 779-2273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 19864 | TX | Yes |

## Other

- **Enumeration date:** 10/15/2014
- **Last updated:** 03/20/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 007804006 | — | TX |