Provider Demographics
NPI: | 1104966738 |
---|---|
Name: | AMERICARE DENTAL CENTER INC |
Entity type: | Organization |
Organization Name: | AMERICARE DENTAL CENTER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | HADY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ATTAR-OLYAEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | D D S |
Authorized Official - Phone: | 713-455-5700 |
Mailing Address - Street 1: | 12450 EAST FWY |
Mailing Address - Street 2: | SUITE 140 |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77015-5534 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-455-5700 |
Mailing Address - Fax: | 713-455-4945 |
Practice Address - Street 1: | 12450 EAST FWY |
Practice Address - Street 2: | SUITE 140 |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77015-5534 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-455-5700 |
Practice Address - Fax: | 713-455-4945 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-06 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 18110 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |