Individual
DR. FAREEDA BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
2121 E OLTORF ST, AUSTIN, TX 78741-4500
(949) 800-9524
Mailing address
2121 E OLTORF ST, AUSTIN, TX 78741-4500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33831
TX
Other
Enumeration date
07/27/2016
Last updated
11/19/2021
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