Provider Demographics
NPI:1124101472
Name:HIRT, FREDERICK E (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:E
Last Name:HIRT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W BAY AREA BLVD
Mailing Address - Street 2:STE 604
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4041
Mailing Address - Country:US
Mailing Address - Phone:281-338-1235
Mailing Address - Fax:281-338-5009
Practice Address - Street 1:711 W BAY AREA BLVD
Practice Address - Street 2:STE 604
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4041
Practice Address - Country:US
Practice Address - Phone:281-338-1235
Practice Address - Fax:281-338-5009
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist