Provider Demographics
NPI:1306646286
Name:HOUSTON METHODIST ORAL AND MAXILLOFACIAL SURGEONS, PLLC
Entity type:Organization
Organization Name:HOUSTON METHODIST ORAL AND MAXILLOFACIAL SURGEONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE CYCLE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-302-9682
Mailing Address - Street 1:6560 FANNIN ST STE 1280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2753
Mailing Address - Country:US
Mailing Address - Phone:713-441-5577
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 1280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2753
Practice Address - Country:US
Practice Address - Phone:713-441-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty