| NPI | 1710126768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANNE STEARNS Office Manager 936-539-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 22205) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2026-08-12 |