Provider Demographics
NPI:1639596539
Name:WOERNLEY, TIMOTHY CHARLES III (DDS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CHARLES
Last Name:WOERNLEY
Suffix:III
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 1:7500 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 6510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2032
Mailing Address - Country:US
Mailing Address - Phone:713-486-4125
Mailing Address - Fax:713-486-4333
Practice Address - Street 1:7500 CAMBRIDGE ST
Practice Address - Street 2:SUITE 6510
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2032
Practice Address - Country:US
Practice Address - Phone:713-486-4125
Practice Address - Fax:713-486-4333
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX307411223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program