Individual provider Active NPI

Andrew M Read-Fuller

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dallas, TX
National Provider Identifier
1194024190
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
R2208 Issued in TX
Practice address
3302 Gaston Ave
Dallas, TX 75246-2013
Phone
(212) 828-8965
NPI assigned
Mar 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X R2208 TX Primary

Addresses

Primary practice location

3302 Gaston Ave
Dallas, TX 75246-2013

Mailing address

1855 Payne St Apt 619
Dallas, TX 75201-2577

Other practice location 1

421 Wayne Ave # A
Oakland, CA 94606-1150
Phone (510) 387-6233

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021002057 TX Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 2365774577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Univ of Calif, Los Angeles School of Dentistry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Aandm University System Health Science CenterGroup PAC ID 3173931292, 9 clinicians

Practice addresses (Care Compare)

3000 Gaston Ave
Dallas, TX 75226-1309
Phone (214) 828-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31760TXMDPsychologist
R2208TXMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center PastSince Sep 27, 2020 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1194024190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 PAYNE ST APT 619",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462013",
            "telephone_number": "212-828-8965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Wayne Ave # A",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946061150",
            "country_code": "US",
            "telephone_number": "510-387-6233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "READ-FULLER",
        "first_name": "ANDREW",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-16",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "R2208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.