Provider Demographics
NPI:1275422479
Name:BACHNAK, SOUHAD (DDS)
Entity type:Individual
Prefix:DR
First Name:SOUHAD
Middle Name:
Last Name:BACHNAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 FOX HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5828
Mailing Address - Country:US
Mailing Address - Phone:361-688-7592
Mailing Address - Fax:
Practice Address - Street 1:9929 S PADRE ISLAND DR STE 119
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5148
Practice Address - Country:US
Practice Address - Phone:361-937-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist