Organization
PEARLAND ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSANNE MARIE FARRIS (OFFICE MANAGER)
(832) 687-4359
Entity
Organization
Contact information
Practice address
10905 MEMORIAL HERMANN DR, SUITE 100, PEARLAND, TX 77584-3490
(713) 340-0515
(713) 340-0518
Mailing address
10905 MEMORIAL HERMANN DR STE 100, PEARLAND, TX 77584-3490
(713) 340-0515
(713) 340-0518
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19665
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
20025
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22872
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043249287
NPI
TX
01
—
1457483372
NPI
TX
01
—
1750438735
NPI
TX
Enumeration date
11/14/2007
Last updated
11/14/2007
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