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

Lake Jackson Oral and Maxillofacial Surgery, PLLC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1831557370

Lake Jackson Oral and Maxillofacial Surgery, PLLC is an Oral and Maxillofacial Surgery (Dentist) in Lake Jackson, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
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

103 Abner Jackson Pkwy
Lake Jackson, TX 77566-5163
Phone: (979) 299-6878
Fax: (979) 299-6166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 16829 (TX)

Record details

NPI number1831557370
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nathan Phillips — Provider · (979) 299-6878
NPI enumeratedJanuary 28, 2016
Last updated in NPPESJanuary 28, 2016
Mailing address103 Abner Jackson Pkwy, Lake Jackson, TX 77566-5163

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