Provider Demographics
NPI:1114018942
Name:WALTER C ROYE DDS PC
Entity Type:Organization
Organization Name:WALTER C ROYE DDS PC
Other - Org Name:DBA CIMARRON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-349-2222
Mailing Address - Street 1:8500 N MOPAC
Mailing Address - Street 2:SUITE 901
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-349-2222
Mailing Address - Fax:512-349-9115
Practice Address - Street 1:8500 N MOPAC
Practice Address - Street 2:SUITE 901
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-349-2222
Practice Address - Fax:512-349-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD113351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty