Provider Demographics
NPI:1669861134
Name:FERNANDES, ANDREA SYLVIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:SYLVIA
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 TIDWELL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-6816
Mailing Address - Country:US
Mailing Address - Phone:832-564-1800
Mailing Address - Fax:
Practice Address - Street 1:3301 TIDWELL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-6816
Practice Address - Country:US
Practice Address - Phone:832-564-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice