# ORAL AND FACIAL SURGERY INSTITUTE PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oral and Facial Surgery Institute of Houston
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861971236
- **Authorized official:** GINA CASU (CREDENTIALING MANAGER)
- **Authorized official phone:** (713) 790-6477

## Contact information

- **Practice address:** 6560 FANNIN ST STE 1522, HOUSTON, TX 77030
- **Practice address phone:** (713) 790-6477
- **Practice address fax:** (713) 790-6416
- **Mailing address:** 6560 FANNIN ST STE 1522, HOUSTON, TX 77030-2705
- **Mailing address phone:** (713) 790-6477
- **Mailing address fax:** (713) 790-6416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 30279 | TX | Yes |

## Other

- **Enumeration date:** 08/07/2018
- **Last updated:** 08/08/2018