Provider Demographics
NPI:1326234832
Name:ANDERSON, LOUIS D II (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:D
Last Name:ANDERSON
Suffix:II
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21685 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2512
Mailing Address - Country:US
Mailing Address - Phone:281-578-0008
Mailing Address - Fax:281-578-0266
Practice Address - Street 1:21685 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2512
Practice Address - Country:US
Practice Address - Phone:281-578-0008
Practice Address - Fax:281-578-0266
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics