Maxillofacial Surgery Services of Central Texas, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22953 Issued in TX

Legal business name

MAXILLOFACIAL SURGERY SERVICES OF CENTRAL TEXAS, PLLC

Practice address

10801 N Mopac Expy
BLDG 2 Suite 130
Austin, TX 78759-5459

Phone

(512) 372-6230

Fax

(512) 372-6233

NPI assigned

Sep 15, 2011

Last updated

Sep 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Juan F Gonzalez, DMD

Title

Owner / Principal Member

Phone

(210) 380-5576

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1437431442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 N MOPAC EXPY",
            "address_2": "BLDG 2 SUITE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595459",
            "telephone_number": "512-372-6230",
            "fax_number": "512-372-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 N MOPAC EXPY",
            "address_2": "BLDG 2 SUITE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595459",
            "telephone_number": "512-372-6230",
            "fax_number": "512-372-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLOFACIAL SURGERY SERVICES OF CENTRAL TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER / PRINCIPAL MEMBER",
        "authorized_official_telephone_number": "210-380-5576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Austin, TX
• Providers in Austin, 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 Sep 15, 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.