# CLEAR LAKE ORAL AND MAXILLOFACIAL SURGEYY, PLLC

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

## Provider details

- **NPI number:** 1245588169
- **Authorized official:** GHOLAM REZA ZAKHIREH DMD (MANAGER/PRESIDENT)
- **Authorized official phone:** (281) 338-7700

## Contact information

- **Practice address:** 17448 HIGHWAY 3 STE 170, WEBSTER, TX 77598-4139
- **Practice address phone:** (281) 338-7700
- **Practice address fax:** (281) 338-7703
- **Mailing address:** 17448 HIGHWAY 3 STE 170, WEBSTER, TX 77598-4139
- **Mailing address phone:** (281) 338-7700
- **Mailing address fax:** (281) 338-7703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 13577 | TX | Yes |

## Other

- **Enumeration date:** 08/27/2012
- **Last updated:** 08/27/2012