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General NPI Number Information
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NPI Number | 1316315849
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Entity Type | Organization
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Legal Business Name | HOUSTON PLASTIC AND RECONSTRUCTIVE SURGERY
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 575 E MEDICAL CENTER BLVD
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City | WEBSTER
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State | TX
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Zip | 77598-4326
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Country | US
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Telephone | 281-282-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 575 E MEDICAL CENTER BLVD
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City | WEBSTER
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State | TX
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Zip | 77598-4326
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Country | US
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Telephone | 281-282-9555
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SAMMY SIU
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Credential |
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Telephone | 281-282-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | G8291
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | M8291
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License Number State | TX
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