NPIMap

Organization Active NPI

Oral and Maxillofacial Surgeons of Northeast Texas, P. a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Texarkana, TX
National Provider Identifier
1902052095
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL AND MAXILLOFACIAL SURGEONS OF NORTHEAST TEXAS, P. A.
Practice address
1701 Moores LN
Texarkana, TX 75503-1894
Phone
(903) 794-3331
NPI assigned
Aug 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Dr. Kirby Leon Bunel Jr., D.D.S.NPI 1801992623
Title
President
Phone
(903) 794-3331

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X TX Primary

Addresses

Primary practice location

1701 Moores LN
Texarkana, TX 75503-1894

Mailing address

1701 Moores LN
Texarkana, TX 75503-1894

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1902052095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031894",
            "telephone_number": "903-794-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGEONS OF NORTHEAST TEXAS, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "BUNEL",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-794-3331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.