Provider Demographics
NPI:1619088465
Name:MCLEAN, THERESA KAMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:KAMAS
Last Name:MCLEAN
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 1:1123 LEHALL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4911
Mailing Address - Country:US
Mailing Address - Phone:713-790-1314
Mailing Address - Fax:713-790-9296
Practice Address - Street 1:1123 LEHALL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4911
Practice Address - Country:US
Practice Address - Phone:713-790-1314
Practice Address - Fax:713-790-9296
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1391701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice