Provider Demographics
NPI:1568842565
Name:LAMISON, TESSIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:TESSIA
Middle Name:
Last Name:LAMISON
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 1:4410 E RIVERSIDE DR
Mailing Address - Street 2:#150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-4799
Mailing Address - Country:US
Mailing Address - Phone:512-385-4700
Mailing Address - Fax:
Practice Address - Street 1:4410 E RIVERSIDE DR
Practice Address - Street 2:#150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-4799
Practice Address - Country:US
Practice Address - Phone:512-385-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX309221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice