Provider Demographics
NPI:1851431274
Name:GERVAIS, RICHARD E (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:GERVAIS
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 1:3700 BUFFALO SPEEDWAY
Mailing Address - Street 2:SUITE #800
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3700
Mailing Address - Country:US
Mailing Address - Phone:713-772-2111
Mailing Address - Fax:713-888-0556
Practice Address - Street 1:3700 BUFFALO SPEEDWAY
Practice Address - Street 2:SUITE #800
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3700
Practice Address - Country:US
Practice Address - Phone:713-772-2111
Practice Address - Fax:713-888-0556
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice