Healthcare Provider Details

I. General information

NPI: 1508721226
Provider Name (Legal Business Name): LONE STAR ORAL & FACIAL SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 PARIS ST STE A
CASTROVILLE TX
78009-2956
US

IV. Provider business mailing address

1014 PARIS ST STE A
CASTROVILLE TX
78009-2956
US

V. Phone/Fax

Practice location:
  • Phone: 210-263-3442
  • Fax:
Mailing address:
  • Phone: 210-263-3442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: JAMES B MAZOCK
Title or Position: OWNER
Credential: DDS, FACS
Phone: 210-844-4957