| NPI | 1053591479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSANNE MARIE FARRIS Office Manager 832-687-4359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 19665) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 22872) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 20025) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |