Jean Teresa Wade, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

16104 Issued in TX

Practice address

612 Hospital Dr
Andrews, TX 79714-3615

Phone

(432) 523-7782

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457497018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 HOSPITAL DRIVE",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "79714",
            "telephone_number": "432-523-4367",
            "fax_number": "432-524-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 HOSPITAL DR",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797143615",
            "telephone_number": "432-523-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JEAN",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "16104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TX Home Care Group LLC
• United Supermarkets LLC
• Maria Valdivia
• Robert Jess Vasquez, M.D.
• Rand E Waddingham, M.D.
• Jerry Wayne Wade, D.D.S.
• Waldrop Aesthetics & Wellness
• Bailey Nicole Waldrop, FNP-C
• Britney Nicole Walker, LVN
• Wes Tex Urgent Care, PLLC

• Dentist in Andrews, TX
• Providers in Andrews, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.