Provider Demographics
NPI:1104486943
Name:T.E. WALDING DDS, PLLC
Entity type:Organization
Organization Name:T.E. WALDING DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-975-9933
Mailing Address - Street 1:550 WESTCOTT ST STE 448
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5043
Mailing Address - Country:US
Mailing Address - Phone:713-975-9933
Mailing Address - Fax:
Practice Address - Street 1:550 WESTCOTT ST STE 448
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5043
Practice Address - Country:US
Practice Address - Phone:713-975-9933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty