MEDICARE: NORTH TEXAS FACIAL PLASTIC SURGERY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician

General Provider Information

NPI Number	:	1720920317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS FACIAL PLASTIC SURGERY, PLLC

Provider Business Mailing Address
First Line	:	11970 N CENTRAL EXPY STE 410
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3768
Country	:	US
Telephone Number	:	214-382-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	11970 N CENTRAL EXPY STE 410
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3768
Country	:	US
Telephone Number	:	214-382-5100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COLIN PERO
Credential	:	MD
Telephone Number	:	214-382-5100

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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