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General NPI Number Information
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NPI Number | 1629678800
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Entity Type | Organization
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Legal Business Name | POSH PLASTIC AND RECONSTRUCTIVE SURGERY PLLC
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 1021 MATLOCK RD STE 103
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City | MANSFIELD
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State | TX
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Zip | 76063-3443
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Country | US
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Telephone | 682-400-2152
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Fax | 817-225-2774
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Provider Business Mailing Address
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Address Line | 1021 MATLOCK RD STE 103
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City | MANSFIELD
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State | TX
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Zip | 76063-3443
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Country | US
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Telephone | 682-400-2152
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Fax | 817-225-2774
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Authorized Official
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Title or Position | OWNER
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Name | UZOMA BEN GBULIE
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Credential | MD.
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Telephone | 682-400-2152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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