TEXOMA FACIAL AND ORAL SURGERY
NPI 1255710752
Dentist - Oral and Maxillofacial Surgery in Wichita Falls, TX

Active since May 29, 2015
2304 MIDWESTERN PKWY, SUITE 102, WICHITA FALLS, TX 76308(940) 696-1544 Get Directions Write a Review

NPPES record last updated: May 29, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist
  • Oral and Maxillofacial Surgery

About TEXOMA FACIAL AND ORAL SURGERY

This page provides the complete NPI Profile along with additional information for Texoma Facial And Oral Surgery, a provider established in Wichita Falls, Texas operating as a Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1255710752 assigned on May 2015. The practitioner's primary taxonomy code is 1223S0112X with license number 24871 (TX). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Texoma Facial And Oral Surgery. The authorized official of this NPI record is Mr. Clark Allen Petersen Jr. (Operations Director)

NPI
1255710752 Verify this NPI
Provider Legal Name
WICHITA FALLS ORAL AND FACIAL SURGERY, PLLC
Other Organization Name
TEXOMA FACIAL AND ORAL SURGERY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2304 MIDWESTERN PKWY SUITE 102 WICHITA FALLS, TX 76308
Location Phone
(940) 696-1544
Mailing Address
4447 N CENTRAL EXPY SUITE 110, PMB 434 DALLAS, TX 75205
Mailing Phone
(800) 215-6530
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-29-2015
Last Update Date
05-29-2015
Code Navigator

A dentist like Texoma Facial And Oral Surgery is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Oral and Maxillofacial Surgery

Taxonomy Code
1223S0112X
Type
Dental Providers
License No.
24871
License State
TX
Taxonomy Description
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. CLARK ALLEN PETERSEN JR.

Authorized Official Title
OPERATIONS DIRECTOR
Authorized Official Phone
(618) 402-6622

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dentist (Oral and Maxillofacial Surgery)
2304 MIDWESTERN PKWY, SUITE 102
WICHITA FALLS, TX 76308
Counselor (Professional)
2304 MIDWESTERN PKWY, SUITE 103A
WICHITA FALLS, TX 76308
Counselor (Professional)
2304 MIDWESTERN PKWY, STE. 103A
WICHITA FALLS, TX 76308
Home Health
2304 MIDWESTERN PKWY, STE 206
WICHITA FALLS, TX 76308

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255710752, enumerated as an "organization" on May 29, 2015.

The provider is located at 2304 MIDWESTERN PKWY SUITE 102 WICHITA FALLS, TX 76308 and the phone number is (940) 696-1544.

Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.