Provider Demographics
NPI:1801018239
Name:BLAND, TERRY OWEN (DDS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:OWEN
Last Name:BLAND
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 1:2730 PASADENA BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502
Mailing Address - Country:US
Mailing Address - Phone:713-472-1251
Mailing Address - Fax:713-472-1252
Practice Address - Street 1:2730 PASADENA BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502
Practice Address - Country:US
Practice Address - Phone:713-472-1251
Practice Address - Fax:713-472-1252
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice