Individual
DR. AUSYEH ANGELA TAVAKKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
6206 ANTOINE DR, HOUSTON, TX 77091-2615
(713) 263-8900
Mailing address
4006 SAND MYRTLE DR, HOUSTON, TX 77059
(832) 877-0962
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24041
TX
Other
Enumeration date
06/23/2008
Last updated
02/02/2009
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