Provider Demographics
NPI:1760557979
Name:ROYSTER HERNANDEZ, JOY ANGELINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:ANGELINE
Last Name:ROYSTER HERNANDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOY
Other - Middle Name:ANGIE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:608 GATEWAY CENTRAL
Mailing Address - Street 2:STE 201
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654
Mailing Address - Country:US
Mailing Address - Phone:830-693-7044
Mailing Address - Fax:830-693-2069
Practice Address - Street 1:608 GATEWAY CENTRAL STE 201
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6356
Practice Address - Country:US
Practice Address - Phone:830-693-7044
Practice Address - Fax:830-693-2069
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007788503Medicaid
TX007788502Medicaid