Provider Demographics
NPI:1881850766
Name:TEXAS ORAL AND MAXILLOFACIAL SURGERY, P.A.
Entity Type:Organization
Organization Name:TEXAS ORAL AND MAXILLOFACIAL SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:214-824-8960
Mailing Address - Street 1:3001 KNOX ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5584
Mailing Address - Country:US
Mailing Address - Phone:214-824-8960
Mailing Address - Fax:214-824-8984
Practice Address - Street 1:3001 KNOX ST
Practice Address - Street 2:SUITE 301
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5584
Practice Address - Country:US
Practice Address - Phone:214-824-8960
Practice Address - Fax:214-824-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery