Individual
DR. PEDRAM KHOSRAVIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1920 CORPORATE DR. STE 107A, SAN MARCOS, TX 78666
(512) 722-6338
Mailing address
1920 CORPORATE DR. STE 107A, SAN MARCOS, TX 78666
(512) 722-6338
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
25904
TX
1223G0001X
General Practice Dentistry
25904
TX
1223G0001X
General Practice Dentistry
58700
CA
Other
Enumeration date
08/31/2009
Last updated
12/13/2013
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