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General NPI Number Information
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NPI Number | 1942611793
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Entity Type | Organization
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Legal Business Name | PIERCE PLASTIC SURGERY, PLLC
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD PAVILION II, SUITE 441
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 832-647-7488
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Fax |
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Provider Business Mailing Address
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Address Line | 221 W COLORADO BLVD PAVILION II, SUITE 441
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 832-647-7488
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. PAUL MICHAEL PIERCE
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Credential | M.D.
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Telephone | 832-647-7488
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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 | P9246
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License Number State | TX
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