Roanne Shoubaki
Dentist, General Practice in Georgetown, TX. Individual provider (NPI-1).
NPI number1053005504
StatusActive
Last updated in NPPESJul 17, 2025
Details
- NPI
- 1053005504
- Entity type
- Individual (NPI-1)
- Name
- Roanne Shoubaki
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 7, 2023
- Certification date
- Jul 17, 2025
- Last updated
- Jul 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 39434 | TX | Yes |
| 122300000X | Dentist | 39434 | TX |
Practice location
2411 Williams Dr Ste 111Georgetown, TX 78628-3268
Phone 877-800-5722
Mailing address
2423 Williams Dr Ste 107Georgetown, TX 78628-3269
Phone 877-800-5722
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