Provider Demographics
NPI:1659402253
Name:HERVAS, CHRISTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:HERVAS
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 1:5801 YORK BRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2210
Mailing Address - Country:US
Mailing Address - Phone:512-699-7563
Mailing Address - Fax:
Practice Address - Street 1:8015 SHOAL CREEK BLVD STE 108
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8051
Practice Address - Country:US
Practice Address - Phone:512-454-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice