Organization
BRAZOS VALLEY OMS PLLC
Active
Other names
Brazos Valley Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BRYAN GARRETT DDS, MD (OWNER/SURGEON)
(979) 764-7101
Entity
Organization
Contact information
Practice address
1505 EMERALD PLAZA, COLLEGE STATION, TX 77845-1501
(979) 764-7101
(979) 764-7115
Mailing address
1505 EMERALD PLAZA, COLLEGE STATION, TX 77845-1501
(979) 764-7101
(979) 764-7115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10404
TX
1223P0300X
Periodontics
10460
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
10404
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
813315
UNITED CONCORDIA
TN
Enumeration date
05/15/2007
Last updated
01/02/2020
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