Provider Demographics
NPI:1194012898
Name:LY, ALYSSA CHAU (DDS)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CHAU
Last Name:LY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHAU
Other - Middle Name:HONG
Other - Last Name:LY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11415 SHANNON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1644
Mailing Address - Country:US
Mailing Address - Phone:281-879-8081
Mailing Address - Fax:
Practice Address - Street 1:11415 SHANNON HILLS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1644
Practice Address - Country:US
Practice Address - Phone:832-576-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice