Provider Demographics
NPI:1013061902
Name:HORNE, RONALD DEE (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DEE
Last Name:HORNE
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 1:1303 SILVER HILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7424
Mailing Address - Country:US
Mailing Address - Phone:512-306-0773
Mailing Address - Fax:
Practice Address - Street 1:4306 MEDICAL PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3312
Practice Address - Country:US
Practice Address - Phone:512-454-6744
Practice Address - Fax:512-419-0133
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD127401223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12740Medicare ID - Type Unspecified
TXT13915Medicare UPIN