Provider Demographics
NPI:1871762039
Name:LADRILLO, TERESITA E (DMD MPH)
Entity type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:E
Last Name:LADRILLO
Suffix:
Gender:F
Credentials:DMD MPH
Other - Prefix:DR
Other - First Name:TESS
Other - Middle Name:E
Other - Last Name:LADRILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 88361
Mailing Address - Street 2:CITY OF HOUSTON HEALTH & HUMAN SERVICES
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8861
Mailing Address - Country:US
Mailing Address - Phone:713-794-9104
Mailing Address - Fax:713-798-0803
Practice Address - Street 1:1809 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009
Practice Address - Country:US
Practice Address - Phone:713-547-8079
Practice Address - Fax:713-547-8130
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23164122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist