Individual
DR. BRAD A THERIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2501 W WILLIAM CANNON DR, SUITE 6B, AUSTIN, TX 78745-5281
(512) 447-6684
Mailing address
711 W 38TH ST, SUITE A-1, AUSTIN, TX 78705-1121
(512) 454-1220
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
13698
TX
Other
Enumeration date
02/07/2006
Last updated
09/04/2014
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