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General NPI Number Information
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NPI Number | 1699114702
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Entity Type | Organization
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Legal Business Name | DOWNEY PLASTIC SURGERY PLLC
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 1009 MISSOURI ST
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City | HOUSTON
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State | TX
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Zip | 77006-2839
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Country | US
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Telephone | 713-797-0526
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Fax |
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Provider Business Mailing Address
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Address Line | 4722 WARING ST
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City | HOUSTON
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State | TX
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Zip | 77027-6220
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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 | MANAGER
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Name | CARA RYAN BULLOCKS
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Credential | M.D.
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Telephone | 713-775-8556
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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 | P4303
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License Number State | TX
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