Provider Demographics
NPI:1447269097
Name:CODY, TERESA ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANN
Last Name:CODY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HIGHWAY 6
Mailing Address - Street 2:SUITE 185
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4914
Mailing Address - Country:US
Mailing Address - Phone:281-242-0241
Mailing Address - Fax:281-242-3421
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE 185
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-242-0241
Practice Address - Fax:281-242-3421
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice