Elite Oral Surgery Conroe PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ELITE ORAL SURGERY CONROE PLLC

Practice address

15260 TX 105 W
Suite 154
Montgomery, TX 77356

Phone

(832) 416-1341

Fax

(832) 529-1461

NPI assigned

Jun 29, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Jackie Carranza

Title

General Manager/HR

Phone

(281) 256-8400

Specialties & licenses 1

Addresses

Other names 1

• Elite Oral & Facial Surgery Conroe Doing business as

Locations

Practitioners 3

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

• Ali Alkola, DMD, BDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Cypress, TX
  • NPI 1407395064
  NPD (past)
• Alex Ghassan Bachoura, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Cypress, TX
  • NPI 1487885083
  NPD (past)
• Andrew Martin Bhagyam, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Houston, TX
  • NPI 1073976890
  NPD (past)

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1336826593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15260 TX 105 W",
            "address_2": "SUITE 154",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "77356",
            "telephone_number": "832-416-1341",
            "fax_number": "832-529-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15260 TX 105 W",
            "address_2": "SUITE 154",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "77356",
            "telephone_number": "832-416-1341",
            "fax_number": "832-529-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORAL SURGERY CONROE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "CARRANZA",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "GENERAL MANAGER/HR",
        "authorized_official_telephone_number": "281-256-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Oral & Facial Surgery Conroe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Durand Medical Clinic PA
• Karen Marie Earwood, RN
• Jami Eaton
• John M Ehret, DPM
• Eileen Borski PLLC
• Emerson Counseling & Wellness Group PLLC
• Arcelia L Emerson
• Empowering Light Counseling, LLC
• Everbright Dental PLLC
• Farley Medical Specialists

• Oral and Maxillofacial Surgery (Dentist) in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.