Organization Active NPI

Rio Grande Oral & Maxillofacial Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Harlingen, TX
National Provider Identifier
1417088972
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
RIO GRANDE ORAL & MAXILLOFACIAL SURGERY, P.C.
Practice address
1622 N Ed Carey Dr
Harlingen, TX 78550-8286
Phone
(956) 428-4258
Fax
(956) 428-4292
NPI assigned
Mar 8, 2007
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Karl F Frey, D.D.SNPI 1821091398
Title
Managing Partner
Phone
(956) 428-4258

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

1622 N Ed Carey Dr
Harlingen, TX 78550-8286

Mailing address

1622 N Ed Carey Dr
Harlingen, TX 78550-8286
Phone (956) 428-4258

Other practice location 1

2330 Central Blvd
Brownsville, TX 78520-8714
Phone (956) 542-2870

Other practice location 2

100 E Pecan Blvd
McAllen, TX 78501-9555
Phone (956) 682-5292

Other identifiers 4

IdentifierTypeStateIssuer
009746103MedicaidTX
009746101MedicaidTX
286457101MedicaidTX
080437901MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110831000789 TX Part B Supplier - Clinic/Group Practice 3678743523 Receives reassigned benefits from 2 practitioners
Practice locations: McAllen, TX; Harlingen, TX; Edinburg, TX; Brownsville, TX

National Provider Directory

National Provider Directory

Locations

2330 Central Blvd
Brownsville, TX 78520
Phone (956) 542-2870

1622 N Ed Carey Dr
Harlingen, TX 78550
Phone (956) 428-4258

100 E Pecan Blvd
McAllen, TX 78501
Phone (956) 682-5292

Practitioners & affiliated clinicians

Practitioners 3

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1417088972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 N ED CAREY DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508286",
            "telephone_number": "956-428-4258",
            "fax_number": "956-428-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 N ED CAREY DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508286",
            "telephone_number": "956-428-4258",
            "fax_number": "956-428-4292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 Central Blvd",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TX",
            "postal_code": "785208714",
            "country_code": "US",
            "telephone_number": "956-542-2870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Pecan Blvd",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785019555",
            "country_code": "US",
            "telephone_number": "956-682-5292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIO GRANDE ORAL & MAXILLOFACIAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "956-428-4258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009746103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009746101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286457101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080437901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.