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SAN ANTONIO ORAL & MAXILLOFACIAL SURGERY ASSOCIATES P.A. NPI 1992243976


NPI Information

NPI: 1992243976
Provider Name: SAN ANTONIO ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A.
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 45D2077609

Address:
4025 E SOUTHCROSS BLVD
BUILDING 1, SUITE #5
SAN ANTONIO, TX
ZIP 78222
Phone: (210) 337-8600
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SAN ANTONIO ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A. is an oral and maxillofacial surgery dentist in San Antonio, TX. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SAN ANTONIO ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.A. NPI is 1992243976. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4025 E SOUTHCROSS BLVD
BUILDING 1, SUITE #5
SAN ANTONIO, TX
ZIP 78222-641
Phone: (210) 337-8600
Fax: (210) 337-8606

The provider's authorized official is James B. Mazock .
The authorized official title is Owner and has the following contact phone number (210) 696-7500.

The CLIA number assigned to this NPI record is 45D2077609 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2017 and was last updated on 2/9/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery19367TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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