Provider Demographics
NPI:1487369930
Name:DR. OMAR HARMOUCHE PLLC
Entity type:Organization
Organization Name:DR. OMAR HARMOUCHE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMOUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-643-2174
Mailing Address - Street 1:229 N MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:TULIA
Mailing Address - State:TX
Mailing Address - Zip Code:79088-2250
Mailing Address - Country:US
Mailing Address - Phone:806-995-4191
Mailing Address - Fax:
Practice Address - Street 1:229 N MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:TULIA
Practice Address - State:TX
Practice Address - Zip Code:79088-2250
Practice Address - Country:US
Practice Address - Phone:806-995-4191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental