Provider Demographics
NPI:1053726596
Name:DE VERA, JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:DE VERA
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 1:2750 HOLLY HALL ST
Mailing Address - Street 2:#1907
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4109
Mailing Address - Country:US
Mailing Address - Phone:713-480-3006
Mailing Address - Fax:
Practice Address - Street 1:6302 BROADWAY ST
Practice Address - Street 2:#150
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7856
Practice Address - Country:US
Practice Address - Phone:281-412-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist