Provider Demographics
NPI:1619677242
Name:LIEU, ANDREW QUOC (DDS)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:QUOC
Last Name:LIEU
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 1:1402 SILVER MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5876
Mailing Address - Country:US
Mailing Address - Phone:832-433-2762
Mailing Address - Fax:
Practice Address - Street 1:2811 BUSINESS CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4161
Practice Address - Country:US
Practice Address - Phone:713-340-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2025-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX414291223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice