| Ezzy Oms Pllc | |
|
11620 Louetta Rd Ste B Houston TX 77070-1282 | |
| (773) 732-8288 | |
| Not Available |
| Full Name | Ezzy Oms Pllc |
|---|---|
| Speciality | Dentist |
| Location | 11620 Louetta Rd Ste B, Houston, Texas |
| Authorized Official Name and Position | Ahmad Millwala (OWNER) |
| Authorized Official Contact | 7737328288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ezzy Oms Pllc 16226 Pinon Vista Dr Houston TX 77095-7196 Ph: (773) 732-8288 | Ezzy Oms Pllc 11620 Louetta Rd Ste B Houston TX 77070-1282 Ph: (773) 732-8288 |
| NPI Number | 1225660046 |
|---|---|
| Provider Enumeration Date | 02/10/2020 |
| Last Update Date | 02/10/2020 |
| Medicare PECOS PAC ID | 5496136764 |
|---|---|
| Medicare Enrollment ID | O20220718002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225660046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Ahmad Ali Millwala |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053579771 PECOS PAC ID: 4981924842 Enrollment ID: I20220718002252 |
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