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Organization
KATY CENTER FOR ORAL AND FACIAL SURGERY
Active
Organization
KATY CENTER FOR ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANIA IMPASTATO (PRACTICE ADMINISTRATOR)
(281) 392-1130
Entity
Organization
Contact information
Practice address
23922 CINCO VILLAGE CENTER BLVD, SUITE 111, KATY, TX 77494-6619
(281) 392-1130
Mailing address
23922 CINCO VILLAGE CENTER BLVD, SUITE 111, KATY, TX 77494-6619
(281) 392-1130
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/23/2016
Last updated
03/31/2025
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