Organization
FATEMEH EBRAHIMI DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI TATARI DDS (CLINICAL DIRECTOR)
(832) 444-9055
Entity
Organization
Contact information
Practice address
6430 RICHMOND AVE STE 110, HOUSTON, TX 77057-5908
(713) 779-2273
Mailing address
7521 SOUTHWEST FWY, HOUSTON, TX 77074-1903
(713) 779-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19864
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007804006
—
TX
Enumeration date
10/15/2014
Last updated
03/20/2019
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