Organization
CORPUS CHRISTI ORAL AND MAXILLOFACIAL SURGEONS PC
Active
Organization
CORPUS CHRISTI ORAL AND MAXILLOFACIAL SURGEONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HENDRICKS (INSURANCE CLERK)
(361) 993-2290
Entity
Organization
Contact information
Practice address
5756 S STAPLES ST F, CORPUS CHRISTI, TX 78413-3796
(361) 993-2290
(361) 992-4961
Mailing address
5756 S STAPLES ST, CORPUS CHRISTI, TX 78413-3796
(361) 993-2290
(361) 992-4961
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098105-01
—
TX
05
—
0811788-01
—
TX
01
—
G60013-1
DELTA TX CHIPS
TX
Enumeration date
06/15/2006
Last updated
01/10/2013
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