Provider Demographics
NPI:1427155951
Name:CRIST, TIMOTHY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALAN
Last Name:CRIST
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24914 STATE HIGHWAY 249 STE 102
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-7605
Mailing Address - Country:US
Mailing Address - Phone:281-873-6942
Mailing Address - Fax:281-520-4347
Practice Address - Street 1:24914 STATE HIGHWAY 249 STE 102
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-7605
Practice Address - Country:US
Practice Address - Phone:281-873-6942
Practice Address - Fax:281-872-0555
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX122771223G0001X
TXTX012277122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice