Provider Demographics
NPI:1659523348
Name:HEMPHILL, CHRISHELLE WILLIAMS (DDS, MBA)
Entity Type:Individual
Prefix:DR
First Name:CHRISHELLE
Middle Name:WILLIAMS
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:DDS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 SOUTHFORK PKWY APT 912
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3773
Mailing Address - Country:US
Mailing Address - Phone:318-564-0595
Mailing Address - Fax:
Practice Address - Street 1:9355 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1516
Practice Address - Country:US
Practice Address - Phone:713-999-0919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA64161223P0221X
TX336051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2893687Medicaid