Provider Demographics
NPI:1548997448
Name:SHEEN, THEA EBERLEIN (DDS)
Entity type:Individual
Prefix:
First Name:THEA
Middle Name:EBERLEIN
Last Name:SHEEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19507 NORTH FWY # 522I-45
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6066
Mailing Address - Country:US
Mailing Address - Phone:281-602-0880
Mailing Address - Fax:
Practice Address - Street 1:19507 INTERSTATE 45
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-6066
Practice Address - Country:US
Practice Address - Phone:281-602-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist