Brent T Black, DDS | |
1505 Emerald Plz, College Station, TX 77845-1501 | |
(979) 764-7101 | |
Not Available |
Full Name | Brent T Black |
---|---|
Gender | Male |
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1505 Emerald Plz, College Station, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144849365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 36416 (Texas) | Primary |
Entity Name | Brazos Valley Oms Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194931303 PECOS PAC ID: 3173943651 Enrollment ID: O20201022000800 |
Mailing Address | Practice Location Address |
---|---|
Brent T Black, DDS 1505 Emerald Plz, College Station, TX 77845-1501 Ph: (979) 764-7101 | Brent T Black, DDS 1505 Emerald Plz, College Station, TX 77845-1501 Ph: (979) 764-7101 |
Emmanuel Sackey, Dentist Medicare: Not Enrolled in Medicare Practice Location: 1530 Texas Ave S Ste 300, College Station, TX 77840 Phone: 979-599-5554 | |
Dr. Monica D Brown, DDS Dentist Medicare: Medicare Enrolled Practice Location: 122 Walton Dr, College Station, TX 77840 Phone: 979-696-8594 Fax: 979-764-6677 | |
Dr. Charles Calvin Hanley, D.D.S. Dentist Medicare: Accepting Medicare Assignments Practice Location: 1505 Emerald Plz, College Station, TX 77845 Phone: 979-764-7101 Fax: 979-764-7115 | |
Dr. Jay M Erickson, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 1275 Arrington Rd Ste 101, College Station, TX 77845 Phone: 979-321-5300 | |
Mustafa Aldabbagh, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1530 Texas Ave S Ste 300, College Station, TX 77840 Phone: 346-247-1277 | |
Dr. Nathan Allen, DDS Dentist Medicare: Medicare Enrolled Practice Location: 11671 Fm 2154 Rd Ste 400, College Station, TX 77845 Phone: 979-399-5101 | |
Dr. Jason Lee Espinoza, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2101 Texas Ave S, College Station, TX 77840 Phone: 979-693-5130 |