Organization
GREATER BEAUMONT ORAL & MAXILLOFACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASHANTH RAVI (DIRECTOR)
(231) 392-2500
Entity
Organization
Contact information
Practice address
2929 CALDER ST STE 302, BEAUMONT, TX 77702-1831
(409) 832-2532
(409) 832-3055
Mailing address
2929 CALDER ST STE 302, BEAUMONT, TX 77702-1831
(409) 832-2532
(409) 832-3055
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
29763
TX
Other
Enumeration date
06/20/2014
Last updated
08/06/2014
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