NPIMap

Organization Active NPI

Houston Methodist Oral and Maxillofacial Surgeons, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Houston, TX
National Provider Identifier
1306646286
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
HOUSTON METHODIST ORAL AND MAXILLOFACIAL SURGEONS, PLLC
Practice address
6560 Fannin St Ste 1280
Houston, TX 77030-2753
Phone
(713) 441-5577
NPI assigned
Mar 18, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
Amy Premetz
Title
VP Revenue Cycle Operations
Phone
(281) 302-9682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

6560 Fannin St Ste 1280
Houston, TX 77030-2753

Mailing address

6560 Fannin St Ste 1280
Houston, TX 77030-2753
Phone (713) 441-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251121002989 TX Part B Supplier - Clinic/Group Practice 3274025739 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1306646286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302753",
            "telephone_number": "713-441-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302753",
            "telephone_number": "713-441-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON METHODIST ORAL AND MAXILLOFACIAL SURGEONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "PREMETZ",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "VP REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "281-302-9682"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.