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General NPI Number Information
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NPI Number | 1063897387
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Entity Type | Organization
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Legal Business Name | MEMORIAL ORAL AND MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 7700 SAN FELIPE ST STE 220
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City | HOUSTON
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State | TX
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Zip | 77063-1612
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Country | US
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Telephone | 713-784-4200
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Fax | 713-784-4201
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Provider Business Mailing Address
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Address Line | 7700 SAN FELIPE ST STE 220
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City | HOUSTON
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State | TX
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Zip | 77063-1612
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Country | US
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Telephone | 713-784-4200
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Fax | 713-784-4201
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. THAI M VUU
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Credential | MD, DDS
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Telephone | 713-784-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | TX
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