Provider Demographics
NPI:1669815536
Name:WALTERS, KAREN ALYSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ALYSE
Last Name:WALTERS
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 1:8526 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4003
Mailing Address - Country:US
Mailing Address - Phone:713-790-1111
Mailing Address - Fax:713-790-1117
Practice Address - Street 1:8526 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4003
Practice Address - Country:US
Practice Address - Phone:713-790-1111
Practice Address - Fax:713-790-1117
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist