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General NPI Number Information
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NPI Number | 1578508057
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Entity Type | Organization
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Legal Business Name | ADVANCED AESTHETIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 8900 E RAINTREE DR STE 200
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-7307
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Country | US
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Telephone | 480-752-7874
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Fax | 480-842-8760
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Provider Business Mailing Address
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Address Line | PO BOX 207435
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City | DALLAS
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State | TX
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Zip | 75320-7433
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Country | US
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Telephone | 480-625-0003
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Fax | 480-842-8760
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. PABLO ANDRES PRICHARD
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Credential | M.D.
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Telephone | 602-331-7811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 34430
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License Number State | AZ
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