| |
1015 E Braker Ln Ste 2-3 Austin TX 78753-3449 | |
(512) 832-1121 | |
(877) 833-4825 |
Full Name | |
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Speciality | Dentist |
Location | 1015 E Braker Ln Ste 2-3, Austin, Texas |
Authorized Official Name and Position | Fakeri Zayed (DENTIST) |
Authorized Official Contact | 5125690274 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1015 E Braker Ln Ste 2-3 Austin TX 78753-3449 Ph: (512) 832-1121 | 1015 E Braker Ln Ste 2-3 Austin TX 78753-3449 Ph: (512) 832-1121 |
NPI Number | 1780968362 |
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Provider Enumeration Date | 09/30/2011 |
Last Update Date | 10/31/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780968362 | NPI | - | NPPES |
1487871901 | Medicaid | TX | |
1326114968 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 21278 (Texas) | Primary |
122300000X | Dentist | 22714 (Texas) | Secondary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |