Provider Demographics
NPI:1528457629
Name:CENTRAL TEXAS ORAL HEALTH PLLC
Entity type:Organization
Organization Name:CENTRAL TEXAS ORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZIM
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-797-6321
Mailing Address - Street 1:5625 EIGER RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8977
Mailing Address - Country:US
Mailing Address - Phone:512-386-1229
Mailing Address - Fax:512-394-5966
Practice Address - Street 1:5625 EIGER RD
Practice Address - Street 2:SUITE 135
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8977
Practice Address - Country:US
Practice Address - Phone:512-386-1229
Practice Address - Fax:512-394-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty