DR. BRANDON COLT CLYBURN (NPI# 1619104759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619104759 |
| Entity Type | Individual |
| Full Name | DR. BRANDON COLT CLYBURN |
| Credential | D.D.S. |
| Practice Address |
1505 Emerald Plz College Station TX 77845-1501 |
| Practice Telephone | 9797647101 |
| Mailing Telephone | 9797647101 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 24644 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1505 EMERALD PLZ |
| City | COLLEGE STATION |
| State | TX |
| Zip Code | 77845-1501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891044012 | Garrett Blundell | Dentist | 1505 Emerald Plz, College Station, TX 77845-1501 | 2012-09-04 |
| 1184910838 | James Bryan Garrett | Dentist | 1505 Emerald Plz, College Station, TX 77845-1501 | 2011-06-21 |
| 1023322187 | Charles Calvin Hanley | Dentist | 1505 Emerald Plz, College Station, TX 77845-1501 | 2010-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503101 | Aggieland Urgent Care Pllc | Clinic/Center | 13055 Fm 2154 Rd, College Station, TX 77845 | 2019-11-19 |
| 1770053399 | Alyssa Nicole Sanchez | Licensed Vocational Nurse | 4030 Hwy 6 S 150, College Station, TX 77845 | 2018-11-27 |
| 1154805778 | Medical Care Innovation, P.C. | Clinic/Center | 200 Quality Circle, College Station, TX 77845 | 2018-09-19 |
| 1003302530 | Kaye Lynn Tseng | Registered Nurse | 4030 Hightway 6 South, College Station, TX 77845 | 2018-07-09 |
| 1083117907 | College Station Dentistry and Orthodontics Pllc | Dentist | 11671 Fm 2154, Suite 400, College Station, TX 77845 | 2018-03-16 |
| 1912409954 | H-e-b, Lp | Clinical Medical Laboratory | 11675 Fm 2154, College Station, TX 77845 | 2018-03-06 |
| 1871095745 | Gregory Nicholas Perry | Physical Therapist | 4091 Sh 6 South, Suite B, College Station, TX 77845 | 2018-03-06 |
| 1811435639 | Michael Patke | Student in an Organized Health Care Education/Training Program | 10613 Deer Run Dr., College Station, TX 77845 | 2017-02-01 |
| 1558810473 | Sara Beth Williamson | Nurse Practitioner | 4401 State Hwy 6 S, College Station, TX 77845 | 2016-10-04 |
| 1881067379 | Kieshia Lewis | Occupational Therapy Assistant | 2700 Earl Rudder Frwy Suite 1200, College Station, TX 77845 | 2015-11-05 |
| Find all providers in zip 77845 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477101053 | College Station Oral Surgery, Pllc | Oral & Maxillofacial Surgery | 1645 Greens Prairie Rd W Ste 202, College Station, TX 77845-8414 | 2019-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922579473 | Christopher M. King, Dds, Md, Pllc | Oral & Maxillofacial Surgery | 5209 Heritage Ave Ste 220, Colleyville, TX 76034-5997 | 2018-12-10 |
| 1063908671 | Steven C. Albright Dds, Pa | Oral & Maxillofacial Surgery | 15600 San Pedro Ave Ste 107, San Antonio, TX 78232 | 2018-07-06 |
| 1508375965 | Dioms, Pllc | Oral & Maxillofacial Surgery | 9676 Bartlett Cir Ste 950, Fort Worth, TX 76108-4469 | 2017-09-28 |
| 1730625740 | Facial Head & Neck Surgery Pllc | Oral & Maxillofacial Surgery | 2317 Coit Rd Ste A, Plano, TX 75075-3774 | 2017-01-13 |
| 1821405416 | Caprock Oral Surgery, Pllc | Oral & Maxillofacial Surgery | 5730 66th St., Lubbock, TX 79424-1224 | 2014-07-16 |
| 1487997813 | Amir All-atabakhsh | Oral & Maxillofacial Surgery | 2402 Rice Blvd Ste C, Houston, TX 77005-3203 | 2013-04-04 |
| 1225398456 | Associates In Oral & Implant Surgery | Oral & Maxillofacial Surgery | 7211 North Mesa Suite 1 South, El Paso, TX 79912 | 2012-05-22 |
| 1437419652 | Associates In Oral & Implant Surgery | Oral & Maxillofacial Surgery | 7211 North Mesa Suite 1-south, El Paso, TX 79912 | 2012-05-22 |
| 1689954562 | Roderick Youngdo Kim | Oral & Maxillofacial Surgery | 1500 S Main St Dept Of, Fort Worth, TX 76104-4917 | 2011-08-23 |
| 1891923843 | Blake Dyson Maida | Oral & Maxillofacial Surgery | 7500 San Felipe St Ste 300, Houston, TX 77063-1716 | 2009-06-29 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE STATION |
| Zip Code | 77845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.