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General NPI Number Information
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NPI Number | 1386006237
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY AND BREAST RECONSTRUCTION ASSOCIATION OF NORTH TEXAS
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Dates
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Enumeration Date | 03/21/2016
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 10830 N CENTRAL EXPY SUITE 120
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City | DALLAS
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State | TX
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Zip | 75231-1050
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Country | US
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Telephone | 214-378-9898
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Fax | 214-378-9888
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Provider Business Mailing Address
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Address Line | PO BOX 670039
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City | DALLAS
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State | TX
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Zip | 75367-0039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANGELA JONES
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Credential |
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Telephone | 214-378-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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