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General NPI Number Information
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NPI Number | 1487082590
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Entity Type | Organization
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Legal Business Name | ORAL AND FACIAL COSMETIC SURGERY PA
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 2450 FONDREN RD STE 130
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City | HOUSTON
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State | TX
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Zip | 77063-2398
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Country | US
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Telephone | 713-266-1999
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Fax | 713-266-4408
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Provider Business Mailing Address
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Address Line | 2450 FONDREN RD STE 130
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City | HOUSTON
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State | TX
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Zip | 77063-2398
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Country | US
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Telephone | 713-266-1999
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Fax | 713-266-4408
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER P BYRNE
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Credential | DDS, MD
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Telephone | 713-266-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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