# KATY CENTER FOR ORAL AND FACIAL SURGERY

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

## Provider details

- **NPI number:** 1053762823
- **Authorized official:** TANIA IMPASTATO (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (281) 392-1130

## Contact information

- **Practice address:** 23922 CINCO VILLAGE CENTER BLVD, SUITE 111, KATY, TX 77494-6619
- **Practice address phone:** (281) 392-1130
- **Mailing address:** 23922 CINCO VILLAGE CENTER BLVD, SUITE 111, KATY, TX 77494-6619
- **Mailing address phone:** (281) 392-1130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2016
- **Last updated:** 03/31/2025