Provider Demographics
NPI:1972948503
Name:DONALD, TIA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIA
Middle Name:ELIZABETH
Last Name:DONALD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21843 KING HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1376
Mailing Address - Country:US
Mailing Address - Phone:713-578-0999
Mailing Address - Fax:
Practice Address - Street 1:5900 NORTH FWY STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-4041
Practice Address - Country:US
Practice Address - Phone:713-578-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX392511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice