Provider Demographics
NPI:1538323183
Name:URBINA, THERESE MADELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:MADELLE
Last Name:URBINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:THERESE
Other - Middle Name:MADELLE
Other - Last Name:CALDERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:905 SAINT HELENA DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641
Mailing Address - Country:US
Mailing Address - Phone:713-504-7798
Mailing Address - Fax:
Practice Address - Street 1:940 PAYTON GIN RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6720
Practice Address - Country:US
Practice Address - Phone:713-947-9800
Practice Address - Fax:713-947-9843
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23912122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist