Provider Demographics
NPI:1114082799
Name:WATKINS, ANDREW WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:WATKINS
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 1:1930 COUNTRY PLACE PKWY.
Mailing Address - Street 2:STE. 104
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2137
Mailing Address - Country:US
Mailing Address - Phone:713-436-7143
Mailing Address - Fax:713-436-7965
Practice Address - Street 1:1930 COUNTRY PLACE PKWY.
Practice Address - Street 2:STE. 104
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2137
Practice Address - Country:US
Practice Address - Phone:713-436-7143
Practice Address - Fax:713-436-7965
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice