Healthcare Provider Details

I. General information

NPI: 1780494179
Provider Name (Legal Business Name): RYU ORAL & MAXILLOFACIAL SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 MAIN ST STE 702
KATY TX
77494-0541
US

IV. Provider business mailing address

1325 MAIN ST STE 702
KATY TX
77494-0541
US

V. Phone/Fax

Practice location:
  • Phone: 281-394-3986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: BRIAN RYU
Title or Position: DOCTOR
Credential: DMD
Phone: 334-462-8079