Organization
BRAVO DENTAL CLINICS PA
Active
Other names
bravo dental clinics pa
Organization subpart
No
Provider details
NPI number
Authorized official
FH FARZAM MS DDS (DENTIST)
(713) 453-3733
Entity
Organization
Contact information
Practice address
779 NORMANDY ST STE 113, HOUSTON, TX 77015-3441
(713) 453-3733
(713) 453-3446
Mailing address
779 NORMANDY ST STE 113, HOUSTON, TX 77015
(713) 453-3733
(713) 453-3446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18688
TX
1223G0001X
General Practice Dentistry
19027
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G600671
CHIPS
TX
Enumeration date
04/26/2007
Last updated
08/22/2020
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