Provider Demographics
NPI:1861384729
Name:MANSURI, ESHAH (DDS)
Entity type:Individual
Prefix:
First Name:ESHAH
Middle Name:
Last Name:MANSURI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 ZABCIKVILLE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2979
Mailing Address - Country:US
Mailing Address - Phone:281-615-5649
Mailing Address - Fax:
Practice Address - Street 1:3731 W FARM TO MARKET 93
Practice Address - Street 2:SUITE 110
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502
Practice Address - Country:US
Practice Address - Phone:254-771-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX417471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice