Provider Demographics
NPI:1598764961
Name:CAGLE, SHIRLEY JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:JEAN
Last Name:CAGLE
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 1:6769 LAKE WOODLANDS DR
Mailing Address - Street 2:STE A
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2770
Mailing Address - Country:US
Mailing Address - Phone:281-681-9442
Mailing Address - Fax:281-681-9445
Practice Address - Street 1:6769 LAKE WOODLANDS DR
Practice Address - Street 2:STE A
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2770
Practice Address - Country:US
Practice Address - Phone:281-681-9442
Practice Address - Fax:281-681-9445
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14731122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist