1366891293 NPI number — BRUSH32 DENTAL OF PFLUGERVILLE PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366891293 NPI number — BRUSH32 DENTAL OF PFLUGERVILLE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRUSH32 DENTAL OF PFLUGERVILLE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366891293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2324 FM 685
Provider Second Line Business Mailing Address:
STE 400
Provider Business Mailing Address City Name:
PFLUGERVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78660-4424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-265-8426
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2324 FM 685
Provider Second Line Business Practice Location Address:
STE 400
Provider Business Practice Location Address City Name:
PFLUGERVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78660-4424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-265-8426
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2016

Additional Information

Authorized Official

Authorized Official Last Name:
AHMED
Authorized Official First Name:
SULMAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
972-361-0600

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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