NPIMap

Organization Active NPI

Kerrville Oral & Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kerrville, TX
National Provider Identifier
1427341502
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
24237 Issued in TX
Legal business name
KERRVILLE ORAL & MAXILLOFACIAL SURGERY, P.A.
Practice address
501 Jefferson St
Suite 2
Kerrville, TX 78028-4561
Phone
(830) 895-3494
Fax
(830) 896-3390
NPI assigned
May 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Dr. Ryan Green
Title
President
Phone
(903) 526-7366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 24237 TX Primary

Addresses

Primary practice location

501 Jefferson St
Suite 2
Kerrville, TX 78028-4561

Mailing address

501 Jefferson St
Suite 2
Kerrville, TX 78028-4561
Phone (830) 895-3494

National Provider Directory

National Provider Directory

Locations

501 Jefferson St
Ste 2
Kerrville, TX 78028
Phone (830) 895-3494

Practitioners & affiliated clinicians

Practitioners 2

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": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1427341502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284561",
            "telephone_number": "830-895-3494",
            "fax_number": "830-896-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284561",
            "telephone_number": "830-895-3494",
            "fax_number": "830-896-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRVILLE ORAL & MAXILLOFACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-526-7366",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.