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General NPI Number Information
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NPI Number | 1720446685
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Entity Type | Organization
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Legal Business Name | RECONSTRUCTIVE ASSOCIATES OF HOUSTON PLLC
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 4126 SOUTHWEST FWY STE 275
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City | HOUSTON
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State | TX
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Zip | 77027-7310
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Country | US
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Telephone | 713-201-6318
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Fax |
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Provider Business Mailing Address
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Address Line | 4126 SOUTHWEST FWY STE 275
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City | HOUSTON
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State | TX
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Zip | 77027-7310
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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 | MANAGING MEMBER
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Name | SCOTT COHEN
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Credential |
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Telephone | 713-201-6318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | H4243
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License Number State | TX
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