Healthcare Provider Details

I. General information

NPI: 1326519208
Provider Name (Legal Business Name): REST RECONSTRUCTION EXPERTISE IN SURGICAL TRAUMA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W 38TH ST STE 206
AUSTIN TX
78731-6405
US

IV. Provider business mailing address

1600 W 38TH ST STE 206
AUSTIN TX
78731-6405
US

V. Phone/Fax

Practice location:
  • Phone: 512-600-2888
  • Fax: 512-842-9228
Mailing address:
  • Phone: 512-600-2888
  • Fax: 512-842-9228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY D CONE JR.
Title or Position: OWNER
Credential: MD
Phone: 512-600-2888