1457843450 NPI number — AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC

Table of content: DR. RAHUL KUMAR BIYANI M.D. (NPI 1225355241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457843450 NPI number — AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFFORDABLE DENTURES & IMPLANTS - TEXAS, 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:
1457843450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8938 S BROADWAY AVE STE 380
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TYLER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75703-5735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-201-8380
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8938 SOUTH BROADWAY
Provider Second Line Business Practice Location Address:
STE 480
Provider Business Practice Location Address City Name:
TYLER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-201-8380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WOOSTER
Authorized Official First Name:
HALEY
Authorized Official Middle Name:
Authorized Official Title or Position:
ENROLLMENT SPECIALIST
Authorized Official Telephone Number:
712-733-8551

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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