NPIMap

Organization Active NPI

West Texas Maxillofacial Surgery PA

  • Oral & Maxillofacial Surgery (D.M.D.)
  • El Paso, TX
National Provider Identifier
1700178555
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
25153 Issued in TX
Legal business name
WEST TEXAS MAXILLOFACIAL SURGERY PA
Practice address
10175 Gateway Blvd W
Suite304
El Paso, TX 79925-7618
Phone
(915) 504-6880
Fax
(915) 599-8579
NPI assigned
May 12, 2011
Organization subpart
Yes
Parent organization
WEST TEXAS MAXILLOFACIAL SURGERY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Authorized official

Name
Vernon P Burke, DMDNPI 1447430178
Title
Director
Phone
(210) 630-9909

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X 25153 TX Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

10175 Gateway Blvd W
Suite304
El Paso, TX 79925-7618

Mailing address

10175 Gateway Blvd W
Suite 304
El Paso, TX 79925-7618
Phone (915) 504-6880

Other names 1

  • High Desert Oral & Facial Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110809000607 TX Part B Supplier - Clinic/Group Practice 9436328473 Receives reassigned benefits from 6 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory
Part of
West Texas Maxillofacial

Locations

10175 Gateway Blvd W
Ste 304
El Paso, TX 79925
Phone (915) 504-6880

210 Thunderbird Dr
Ste V
El Paso, TX 79912
Phone (915) 833-2969

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1700178555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 GATEWAY BLVD W",
            "address_2": "SUITE 304",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257618",
            "telephone_number": "915-504-6880",
            "fax_number": "915-599-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 GATEWAY BLVD W",
            "address_2": "SUITE304",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257618",
            "telephone_number": "915-504-6880",
            "fax_number": "915-599-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS MAXILLOFACIAL SURGERY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST TEXAS MAXILLOFACIAL SURGERY, PA",
        "enumeration_date": "2011-05-12",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "210-630-9909",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "25153",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Desert Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.