Provider Demographics
NPI:1679964787
Name:SHAU, ALEXANDER Y (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:Y
Last Name:SHAU
Suffix:
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 1:13616 N HWY 183 UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2312
Mailing Address - Country:US
Mailing Address - Phone:512-682-5437
Mailing Address - Fax:
Practice Address - Street 1:13616 N HWY 183 UNIT A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2312
Practice Address - Country:US
Practice Address - Phone:512-682-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327531223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry