1992044424 NPI number — DR. EIAD NEHAD ELATHAMNA

Table of content: DR. EIAD NEHAD ELATHAMNA (NPI 1992044424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992044424 NPI number — DR. EIAD NEHAD ELATHAMNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELATHAMNA
Provider First Name:
EIAD
Provider Middle Name:
NEHAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1992044424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON
Provider Second Line Business Mailing Address:
7500 CAMBRIDGE STREET , SUITE 5452
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-486-4471
Provider Business Mailing Address Fax Number:
713-486-4353

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SCHOOL OF DENTISTRY
Provider Second Line Business Practice Location Address:
7500 CAMBRIDGE ST , SUITE 5452
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-486-4471
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  9260 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0700X , with the licence number: 9260 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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