Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

College Station Oral Surgery, PLLC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1477101053

College Station Oral Surgery, PLLC is an Oral & Maxillofacial Surgery (D.M.D.) in College Station, Texas. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1645 Greens Prairie Rd W Ste 202
College Station, TX 77845-8414
Phone: (979) 316-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1477101053
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jackie Carranza — General Manager · (979) 316-5000
NPI enumeratedAugust 28, 2019
Last updated in NPPESAugust 28, 2019
Mailing address24437 Katy Fwy Ste 500, Katy, TX 77494-1469

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