| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3400 Fondren Rd, Houston, Texas |
| Authorized Official Name and Position | Raza Rahgozard (DENTIST) |
| Authorized Official Contact | 2107771225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3400 Fondren Rd Houston TX 77063-5650 Ph: (281) 974-3850 | 3400 Fondren Rd Houston TX 77063 Ph: (281) 974-3850 |
| NPI Number | 1205213816 |
|---|---|
| Provider Enumeration Date | 05/04/2015 |
| Last Update Date | 05/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205213816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 29010 (Texas) | Primary |
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