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General NPI Number Information
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NPI Number | 1225542137
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Entity Type | Organization
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Legal Business Name | TEXAS DENTAL ASSOCIATES, PA
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 3991 RICHMOND AVE
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City | HOUSTON
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State | TX
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Zip | 77027-5803
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Country | US
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Telephone | 713-490-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 AMHERST ST STE A
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City | HOUSTON
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State | TX
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Zip | 77005-3207
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Country | US
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Telephone | 713-490-8880
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Fax | 713-490-6464
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Authorized Official
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Title or Position | OWNER
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Name | DONALD W ANDRESS
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Credential |
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Telephone | 713-490-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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