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General NPI Number Information
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NPI Number | 1497918783
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY CENTER OF AUSTIN
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 6818 AUSTIN CENTER BLVD SUITE 206
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City | AUSTIN
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State | TX
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Zip | 78731-3158
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Country | US
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Telephone | 512-338-4404
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Fax | 512-338-4405
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Provider Business Mailing Address
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Address Line | 6818 AUSTIN CENTER BLVD SUITE 206
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City | AUSTIN
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State | TX
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Zip | 78731-3158
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Country | US
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Telephone | 512-338-4404
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Fax | 512-338-4405
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Authorized Official
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Title or Position | PLASTIC SURGEON
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Name | DAVID MOSIER
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Credential | M.D.
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Telephone | 512-338-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | J5421
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License Number State | TX
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