Provider Demographics
NPI:1417467069
Name:GAVRI, AARON (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:GAVRI
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26440 FM 1093 RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7201
Mailing Address - Country:US
Mailing Address - Phone:281-684-5675
Mailing Address - Fax:
Practice Address - Street 1:26440 FM 1093 RD
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77406
Practice Address - Country:US
Practice Address - Phone:281-407-5871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8986122300000X, 1223X0400X
TX364341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentist