Provider Demographics
NPI:1841313913
Name:BAO, ANDREW AN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:AN
Last Name:BAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:AN
Other - Last Name:BAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7417 S KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3301
Mailing Address - Country:US
Mailing Address - Phone:832-351-2999
Mailing Address - Fax:832-351-2114
Practice Address - Street 1:7417 S KIRKWOOD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3301
Practice Address - Country:US
Practice Address - Phone:832-351-2999
Practice Address - Fax:832-351-2114
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice