Provider Demographics
NPI:1164575585
Name:REN, TU (DDS,)
Entity Type:Individual
Prefix:
First Name:TU
Middle Name:
Last Name:REN
Suffix:
Gender:F
Credentials:DDS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13715 TOMBALL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-2705
Mailing Address - Country:US
Mailing Address - Phone:281-260-8888
Mailing Address - Fax:281-260-8593
Practice Address - Street 1:13715 TOMBALL PARKWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-2705
Practice Address - Country:US
Practice Address - Phone:281-260-8888
Practice Address - Fax:281-260-8593
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB-18838OtherDELTA
TX0094468-01Medicaid