Brazos Oral & Facial Surgery, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

BRAZOS ORAL & FACIAL SURGERY, PA

Doing business as

Brazos Oral & Facial Surgery

Practice address

103 Burnett CT
Waco, TX 76712-3100

Phone

(254) 399-9925

Fax

(254) 399-9930

NPI assigned

Nov 6, 2024

Last updated

Nov 6, 2024By 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

Walter Patrick Armstrong Jr.

Title

Practice Leader

Phone

(254) 399-9925

Specialties & licenses 1

Addresses

Other names 1

• Brazos Oral & Facial Surgery Doing business as

Locations

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.

• Charles Lee Clark, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
  • NPI 1659331650
  NPD (past)
• Corbin A. Gatlin, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Waco, TX
  • NPI 1538504741
  NPD (past)
• Russell Scott Warren, DDS, M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodway, TX
  • NPI 1386822237
  NPD (past)

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1871316968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BURNETT CT",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123100",
            "telephone_number": "254-399-9925",
            "fax_number": "254-399-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BURNETT CT",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123100",
            "telephone_number": "254-399-9925",
            "fax_number": "254-399-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS ORAL & FACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRACTICE LEADER",
        "authorized_official_telephone_number": "254-399-9925",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brazos Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Paul Bray, M.A., LPC-I
• Raymond Paul Bray, LPC
• Brazos Family Dentistry, L.L.P.
• Brazos Foot & Ankle LLC
• Brazos Gi Anesthesia LLC
• Brazos Pulmonary & Sleep Associates PA
• Brazos Valley Eye Physicians PA
• Rochelle B Breemes
• Alex A Breitenwischer, MS, LAT, ATC
• Brent L Kutach DO PA

• Oral and Maxillofacial Surgery (Dentist) in Waco, TX
• Providers in Waco, 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 Nov 6, 2024; 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.