Provider Demographics
NPI:1457942203
Name:ANDRADE, DENA YVETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:YVETTE
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 BUSINESS CENTER DR STE 112
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4168
Mailing Address - Country:US
Mailing Address - Phone:281-249-1142
Mailing Address - Fax:
Practice Address - Street 1:3609 BUSINESS CENTER DR STE 112
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4168
Practice Address - Country:US
Practice Address - Phone:281-249-1142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10099T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist