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Organization

ELEVATED ORAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSANA C PORRAS DMD (MANAGER/OWNER)
(281) 940-5315
Entity
Organization

Contact information

Practice address
1106 WITTE RD STE 300, HOUSTON, TX 77055-2164
(281) 940-5315
Mailing address
1106 WITTE RD STE 300, HOUSTON, TX 77055-2164
(281) 940-5315

Taxonomy

Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary

Other

Enumeration date
08/16/2023
Last updated
08/22/2023
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