Healthcare Provider Details

I. General information

NPI: 1649655341
Provider Name (Legal Business Name): SOUTHWEST HAND AND MICROSURGERY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3108 MIDWAY RD STE 103
PLANO TX
75093-6383
US

IV. Provider business mailing address

3108 MIDWAY RD STE 103
PLANO TX
75093-6383
US

V. Phone/Fax

Practice location:
  • Phone: 214-919-5001
  • Fax: 972-608-0099
Mailing address:
  • Phone: 214-919-5001
  • Fax: 972-608-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberN8806
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberN8806
License Number StateTX

VIII. Authorized Official

Name: ROBERT KWON
Title or Position: OWNER
Credential: MD
Phone: 214-502-2402