Individual provider Active NPI

Andrew Martin Bhagyam, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Houston, TX
National Provider Identifier
1073976890
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
39343 Issued in TX
Practice address
11451 Katy Fwy Ste 200
Houston, TX 77079-0012
Phone
(346) 867-3139
Fax
(346) 406-1526
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X U4742 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 39343 TX Primary

Addresses

Primary practice location

11451 Katy Fwy Ste 200
Houston, TX 77079-0012

Mailing address

11451 Katy Fwy Ste 200
Houston, TX 77079-0012
Phone (346) 867-3139

Other practice location 1

6560 Fannin St Ste 614
Houston, TX 77030-2727
Phone (713) 790-1995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810001190 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537521315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39343TXMDPharmacist
U4742TXMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
College Station Oral Surgery, PLLC Oral & Maxillofacial Surgery PastSince Sep 1, 2019 Accepting new patients
Lighthouse Surgical Holdings PLLC Oral and Maxillofacial Surgery PastSince Jun 22, 2021 Accepting new patients
Elite Oral Surgery Conroe PLLC Oral and Maxillofacial Surgery PastSince Jul 2, 2023 Accepting new patients
Spring Oral Surgery & Dental Implant Center Oral and Maxillofacial Surgery PastSince Mar 28, 2021 Accepting new patients
Katy Periodontology and Oral Surgery PLLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1073976890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11451 KATY FWY STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770790012",
            "telephone_number": "346-867-3139",
            "fax_number": "346-406-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11451 KATY FWY STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770790012",
            "telephone_number": "346-867-3139",
            "fax_number": "346-406-1526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6560 Fannin St Ste 614",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302727",
            "country_code": "US",
            "telephone_number": "713-790-1995",
            "fax_number": "713-790-9562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHAGYAM",
        "first_name": "ANDREW",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "U4742",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "39343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.