Provider Demographics
NPI:1356454763
Name:WEYANDT, TAMMY RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:RENEE
Last Name:WEYANDT
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 1:5805 ANDOVER
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:TX
Mailing Address - Zip Code:75002
Mailing Address - Country:US
Mailing Address - Phone:972-442-5207
Mailing Address - Fax:972-359-6311
Practice Address - Street 1:806 S ALLEN HEIGHTS
Practice Address - Street 2:SUITE 400
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002
Practice Address - Country:US
Practice Address - Phone:972-359-6611
Practice Address - Fax:972-359-6311
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
731266OtherUNITED CONCORDIA
119716OtherUNITED CONCORDIA