Provider Demographics
NPI:1275055535
Name:GOMES, ANDREW SHAGOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SHAGOR
Last Name:GOMES
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 1:21145 SPRING PLAZA DR APT 4108
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-1447
Mailing Address - Country:US
Mailing Address - Phone:214-405-3635
Mailing Address - Fax:
Practice Address - Street 1:1500 RESEARCH FOREST DR STE 220
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77381-7300
Practice Address - Country:US
Practice Address - Phone:281-859-4624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-08
Last Update Date:2017-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice