Provider Demographics
NPI:1063652352
Name:LATHROP, COLIN ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:ANDREW
Last Name:LATHROP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5929 FM 1463 RD
Mailing Address - Street 2:STE 130
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5648
Mailing Address - Country:US
Mailing Address - Phone:832-437-3849
Mailing Address - Fax:
Practice Address - Street 1:5929 FM 1463 RD
Practice Address - Street 2:STE 130
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5648
Practice Address - Country:US
Practice Address - Phone:832-437-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice