Provider Demographics
NPI:1447789953
Name:PIERRE, ALEXIS RAPHAEL IV (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAPHAEL
Last Name:PIERRE
Suffix:IV
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 1:621 S ROSS STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHUAC
Mailing Address - State:TX
Mailing Address - Zip Code:77514
Mailing Address - Country:US
Mailing Address - Phone:409-267-4126
Mailing Address - Fax:409-267-4120
Practice Address - Street 1:621 S ROSS STERLING AVE
Practice Address - Street 2:
Practice Address - City:ANAHUAC
Practice Address - State:TX
Practice Address - Zip Code:77514
Practice Address - Country:US
Practice Address - Phone:409-267-4126
Practice Address - Fax:409-267-4120
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA67841223G0001X
TX383841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice