NPIMap

Organization Active NPI

Katy Periodontology and Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Katy, TX
National Provider Identifier
1285039339
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
24787 Issued in TX
Legal business name
KATY PERIODONTOLOGY AND ORAL SURGERY PLLC
Practice address
24437 Katy Fwy
Suite 500
Katy, TX 77494-1376
Phone
(281) 256-8400
NPI assigned
Oct 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Dr. Alex G BachouraNPI 1487885083
Title
President
Phone
(713) 817-4557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 24787 TX Primary

Addresses

Primary practice location

24437 Katy Fwy
Suite 500
Katy, TX 77494-1376

Mailing address

24437 Katy Fwy
Suite 500
Katy, TX 77494-1376
Phone (281) 256-8400

National Provider Directory

National Provider Directory

Locations

24437 Katy Fwy
Ste 500
Katy, TX 77494
Phone (281) 256-8400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1285039339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24437 KATY FWY",
            "address_2": "SUITE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941376",
            "telephone_number": "281-256-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24437 KATY FWY",
            "address_2": "SUITE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941376",
            "telephone_number": "281-256-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY PERIODONTOLOGY AND ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "BACHOURA",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-817-4557",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.