Provider Demographics
NPI:1083892582
Name:ANDRESS, DONALD W
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:W
Last Name:ANDRESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:W
Other - Last Name:ANDRESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:594 SAWDUST RD # 319
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2215
Mailing Address - Country:US
Mailing Address - Phone:281-383-9783
Mailing Address - Fax:
Practice Address - Street 1:6137 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-3148
Practice Address - Country:US
Practice Address - Phone:713-490-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0066261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics