Provider Demographics
NPI:1225373319
Name:TESSLER ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:TESSLER ORTHODONTICS PLLC
Other - Org Name:KYLE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:TESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:512-800-2003
Mailing Address - Street 1:5401 FM 1626 STE 820
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6066
Mailing Address - Country:US
Mailing Address - Phone:512-800-2003
Mailing Address - Fax:
Practice Address - Street 1:5401 FM 1626 STE 820
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6066
Practice Address - Country:US
Practice Address - Phone:512-800-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX275041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty