# PEARLAND ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053591479
- **Authorized official:** MS. ROSANNE MARIE FARRIS (OFFICE MANAGER)
- **Authorized official phone:** (832) 687-4359

## Contact information

- **Practice address:** 10905 MEMORIAL HERMANN DR, SUITE 100, PEARLAND, TX 77584-3490
- **Practice address phone:** (713) 340-0515
- **Practice address fax:** (713) 340-0518
- **Mailing address:** 10905 MEMORIAL HERMANN DR STE 100, PEARLAND, TX 77584-3490
- **Mailing address phone:** (713) 340-0515
- **Mailing address fax:** (713) 340-0518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 19665 | TX | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 20025 | TX | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22872 | TX | — |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 11/14/2007