Provider Demographics
NPI:1386871481
Name:FARZAM, MELANIE LEBLANC (DDS)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:LEBLANC
Last Name:FARZAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 BUFFALO SPEEDWAY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3700
Mailing Address - Country:US
Mailing Address - Phone:713-871-8800
Mailing Address - Fax:713-871-8881
Practice Address - Street 1:3700 BUFFALO SPEEDWAY
Practice Address - Street 2:SUITE 550
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3700
Practice Address - Country:US
Practice Address - Phone:713-871-8800
Practice Address - Fax:713-871-8881
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice