Individual
DR. DEREK ADAM GAUDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2018 ARMY BLVD, APT A, USA DENTAC, FT SAM HOUSTON, TX 78234
(210) 221-0826
Mailing address
2018 ARMY BLVD, APT A, USA DENTAC, FT SAM HOUSTON, TX 78234
(210) 221-0826
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
105
SD
1223E0200X
Endodontics
Primary
D0521
SD
Other
Enumeration date
02/14/2006
Last updated
06/19/2014
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