Organization
KATY PERIODONTOLOGY AND ORAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX G BACHOURA (PRESIDENT)
(713) 817-4557
Entity
Organization
Contact information
Practice address
24437 KATY FWY, SUITE 500, KATY, TX 77494-1376
(281) 256-8400
Mailing address
24437 KATY FWY, SUITE 500, KATY, TX 77494-1376
(281) 256-8400
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
24787
TX
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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