Richard C Fugler, DDS , MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

16829 Issued in TX

Practice address

103 Abner Jackson Pkwy
Ste a
Lake Jackson, TX 77566

Phone

(979) 299-6878

Fax

(979) 299-6166

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 6, 2021 through May 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lake Jackson Oral and Maxillofacial Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Jackson, TX
  • NPI 1831557370
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1609932078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ABNER JACKSON PKWY",
            "address_2": "STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-299-6878",
            "fax_number": "979-299-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 ABNER JACKSON PKWY",
            "address_2": "STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-299-6878",
            "fax_number": "979-299-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGLER",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "DDS , MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "K6850",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "16829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Casandra Franks Carter, LCSW
• Dedra Deann Frazier, PH.D
• Craig K Freedman, M.D.
• Kim Freeman, MA DMD MS
• Melinda Friudenberg, FNP
• Jessica Fuller
• Functional Healing, PLLC
• Matthew Flordelis Furman, LPC
• Kathryn Nicole Gadbois
• Michele Leigh Gambrel, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Lake Jackson, TX
• Providers in Lake Jackson, 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 Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.