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General NPI Number Information
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NPI Number | 1306646286
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Entity Type | Organization
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Legal Business Name | HOUSTON METHODIST ORAL AND MAXILLOFACIAL SURGEONS, PLLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 6560 FANNIN ST STE 1280
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City | HOUSTON
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State | TX
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Zip | 77030-2753
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Country | US
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Telephone | 713-441-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 6560 FANNIN ST STE 1280
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City | HOUSTON
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State | TX
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Zip | 77030-2753
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Country | US
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Telephone | 713-441-5577
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Fax |
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Authorized Official
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Title or Position | VP REVENUE CYCLE OPERATIONS
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Name | AMY PREMETZ
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Credential |
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Telephone | 281-302-9682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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