Provider Demographics
NPI:1386178101
Name:DIAH, TEJ BHULA (DMD)
Entity type:Individual
Prefix:DR
First Name:TEJ
Middle Name:BHULA
Last Name:DIAH
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 1:27363 PENDLETON TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4266
Mailing Address - Country:US
Mailing Address - Phone:727-415-9381
Mailing Address - Fax:
Practice Address - Street 1:6769 LAKE WOODLANDS DR STE G
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2771
Practice Address - Country:US
Practice Address - Phone:832-610-3123
Practice Address - Fax:281-465-8737
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101284122300000X
TX37112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist