Provider Demographics
NPI:1841590536
Name:BAYTOWN ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:BAYTOWN ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GORME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-422-0511
Mailing Address - Street 1:1004 W STERLING ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-4201
Mailing Address - Country:US
Mailing Address - Phone:281-422-0511
Mailing Address - Fax:281-427-7669
Practice Address - Street 1:1004 W STERLING ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-4201
Practice Address - Country:US
Practice Address - Phone:281-422-0511
Practice Address - Fax:281-427-7669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty