Provider Demographics
NPI:1104992726
Name:ANDREW-VIET HUY LA DDS
Entity type:Organization
Organization Name:ANDREW-VIET HUY LA DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW VIET
Authorized Official - Middle Name:HUY
Authorized Official - Last Name:LA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-494-8188
Mailing Address - Street 1:4645 HWY 6
Mailing Address - Street 2:SUITE G
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-494-8188
Mailing Address - Fax:281-494-8190
Practice Address - Street 1:4645 HWY 6
Practice Address - Street 2:SUITE G
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-494-8188
Practice Address - Fax:281-494-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140595301Medicaid
TX140595302Medicaid