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General NPI Number Information
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NPI Number | 1174570527
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Entity Type | Individual
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Provider Name | MICHEAL EUGENE TREDWAY DDS
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 17222 RED OAK DR SUITE 105
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City | HOUSTON
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State | TX
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Zip | 77090-2674
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Country | US
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Telephone | 281-440-3113
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Fax | 281-440-9307
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Provider Business Mailing Address
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Address Line | 27111 EAST LANA LANE
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City | CONROE
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State | TX
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Zip | 77385
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Country | US
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Telephone | 281-367-4143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9557
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License Number State | TX
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