Provider Demographics
NPI:1194401380
Name:AL DOORI, ABDUL RAHMAN (DMD)
Entity type:Individual
Prefix:
First Name:ABDUL RAHMAN
Middle Name:
Last Name:AL DOORI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21602 REDWOOD BLUFF TRL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:415-941-9244
Mailing Address - Fax:
Practice Address - Street 1:1772 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9005
Practice Address - Country:US
Practice Address - Phone:493-625-5243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39736122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist