MEDICARE: TEXAS DENTAL ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1437603677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS DENTAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	2536 AMHERST ST STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3207
Country	:	US
Telephone Number	:	713-490-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	3745A WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5227
Country	:	US
Telephone Number	:	713-244-7792
Fax Number	:	713-490-0376

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD W ANDRESS
Credential	:	DDS
Telephone Number	:	713-490-8880

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	06/30/2021

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