Provider Demographics
NPI:1669440764
Name:OVERSTREET, HARRY LEROY II (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:LEROY
Last Name:OVERSTREET
Suffix:II
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 1:5525 S STAPLES
Mailing Address - Street 2:A-1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-991-5911
Mailing Address - Fax:
Practice Address - Street 1:5525 S STAPLES
Practice Address - Street 2:A-1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-991-5911
Practice Address - Fax:361-991-5912
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice