Provider Demographics
NPI:1194166736
Name:SHEPHERD, ALEXANDRA (DDS, MPH)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8514 HIGHWAY 6 N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2103
Mailing Address - Country:US
Mailing Address - Phone:832-387-6365
Mailing Address - Fax:
Practice Address - Street 1:8514 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2103
Practice Address - Country:US
Practice Address - Phone:832-387-6365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX290701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice