Provider Demographics
NPI:1629182811
Name:TAPE, MAY W (DDS)
Entity type:Individual
Prefix:DR
First Name:MAY
Middle Name:W
Last Name:TAPE
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 1:5501 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6141
Mailing Address - Country:US
Mailing Address - Phone:281-341-7733
Mailing Address - Fax:281-232-6680
Practice Address - Street 1:5501 AVENUE I
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6141
Practice Address - Country:US
Practice Address - Phone:281-341-7733
Practice Address - Fax:281-232-6680
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009796601Medicaid