KATY PERIODONTOLOGY AND ORAL SURGERY PLLC (NPI# 1285039339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285039339 |
| Entity Type | Organization |
| Organization Name | KATY PERIODONTOLOGY AND ORAL SURGERY PLLC |
| Practice Address |
24437 Katy Fwy Suite 500 Katy TX 77494-1376 |
| Practice Telephone | 2812568400 |
| Mailing Telephone | 2812568400 |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |
| Authorized Official Name | DR. ALEX G BACHOURA (PRESIDENT) |
| Authorized Official Telephone | 7138174557 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
24787 | TX | Dental Providers |
| Street Address |
24437 KATY FWY SUITE 500 |
| City | KATY |
| State | TX |
| Zip Code | 77494-1376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649880899 | Julie Dyan Meyers | Speech-Language Pathologist | 4747 Fm 1463 Suite 900, Katy, TX 77494 | 2020-08-03 |
| 1235763426 | Lucy J Pena | Technician | 28106 Sugarside Glen Dr, Katy, TX 77494 | 2020-02-26 |
| 1063042455 | Wonace LLC | Durable Medical Equipment & Medical Supplies | 2717 Commercial Blvd, E200, Katy, TX 77494 | 2020-01-24 |
| 1801431002 | Justin Lee Landers | Specialist/Technologist | 2818 Fair Chase, Katy, TX 77494 | 2019-11-12 |
| 1285276006 | Chrysalis Group LLC | Pharmacy | 1259 Fm 1463 Suite 700, Katy, TX 77494 | 2019-10-14 |
| 1033760400 | Aaron Moniotte | Pharmacist | 23331 Grand Reserve Dr, Katy, TX 77494 | 2019-09-26 |
| 1467001743 | Julie Hankinson | Technician | 4903 Surrey Park Circle, Katy, TX 77494 | 2019-09-09 |
| 1710532148 | Icome2u Nursing Providers Inc | Nurse Practitioner | 26307 Sundown Cove Lane, Katy, TX 77494 | 2019-08-02 |
| 1881252203 | Encompass Health Rehabilitation Hospital of Katy, LLC | Rehabilitation Hospital | 23331 Grand Reserve Drive, Katy, TX 77494 | 2019-05-31 |
| 1407312945 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 322 Cane Island Pkwy, Katy, TX 77494 | 2019-02-20 |
| Find all providers in zip 77494 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447540638 | Rodolfo O Garza | Dentist | 10605 Spring Green Blvd Ste 200, Katy, TX 77494-3595 | 2011-04-09 |
| 1861498164 | William Jacob Wintersteen | Dentist | 23922 Cinco Village Ctr Blvd, Ste 111, Katy, TX 77494-6619 | 2005-06-22 |
| 1053762823 | Katy Center for Oral and Facial Surgery | Dentist | 23922 Cinco Village Center Blvd, Suite 111, Katy, TX 77494-6619 | 2016-06-23 |
| 1942685276 | Brazos Oral & Maxillofacial Surgery, Pllc | Dentist | 10605 Spring Green Blvd, Suite 200, Katy, TX 77494-4048 | 2015-07-28 |
| 1760690291 | Sejoon Sean Kim | Dentist | 830 S Mason Rd, A-5, Katy, TX 77450-3896 | 2007-05-18 |
| 1801003074 | Justin Brock | Dentist | 23922 Cinco Village Center Blvd, Suite 111, Katy, TX 77494-6619 | 2007-05-17 |
| 1942297510 | Raymond L Wiggins | Dentist | 810 S Mason Rd, Ste 301, Katy, TX 77450-3858 | 2005-09-29 |
| 1477540052 | Texas Oral and Facial Surgery | Dentist | 810 S Mason Rd, Suite 301, Katy, TX 77450-3895 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720337 | Texas Wisdom Teeth Specialists | Dentist | 8409 W Cleburne Rd, Fort Worth, TX 76123-1421 | 2020-11-04 |
| 1932716859 | Gentle Dentistry Inc | Dentist | 1810 S Bowen Rd Ste A, Arlington, TX 76013-3340 | 2020-09-24 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1033733365 | Ernesto Carmona Jr Dds PC | Dentist | 10125a Lake Creek Pkwy, Austin, TX 78729-1711 | 2020-06-02 |
| 1437779691 | Kendall Implant and Oral Surgery | Dentist | 109 Falls Ct Ste 700, Boerne, TX 78006-2984 | 2020-04-17 |
| 1285273847 | Cardenas Dental Implants and Oral Surgery | Dentist | 5460 Paredes Line Rd Ste 197a, Brownsville, TX 78526-9742 | 2019-12-31 |
| 1770134876 | Red River Oral Surgery | Dentist | 4616 Highway 75, Suite 201, Denison, TX 75020 | 2019-09-20 |
| 1316594120 | Mona Stone Dds LLC | Dentist | 4863 Allencrest Ln, Dallas, TX 75244-7710 | 2019-08-26 |
| 1821640822 | Guillen Rivera Oral and Maxillofacial Surgery Pllc | Dentist | 7100 Westwind Dr Ste 110-115, El Paso, TX 79912-1786 | 2019-07-10 |
| 1073173274 | Woodlands Oral & Maxillofacial Surgery | Dentist | 4850 W. Panther Creek Drive Suite 106, The Woodlands, TX 77381 | 2019-06-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.