Healthcare Provider Details

I. General information

NPI: 1033513478
Provider Name (Legal Business Name): PLASTIC SURGERY & ENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 SOUTHWEST FWY SUITE 1210
HOUSTON TX
77027-7310
US

IV. Provider business mailing address

4126 SOUTHWEST FWY SUITE 1210
HOUSTON TX
77027-7310
US

V. Phone/Fax

Practice location:
  • Phone: 713-621-2556
  • Fax: 832-538-1619
Mailing address:
  • Phone: 713-621-2556
  • Fax: 832-538-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAJED IBRAHIM
Title or Position: OWNER
Credential:
Phone: 713-621-2556