MEDICARE: TEXAS INSTITUTE OF PLASTIC SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G0027	TX

General Provider Information

NPI Number	:	1245407626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS INSTITUTE OF PLASTIC SURGERY

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 2200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2334
Country	:	US
Telephone Number	:	713-790-9000
Fax Number	:	713-790-0249

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 2200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2334
Country	:	US
Telephone Number	:	713-790-9000
Fax Number	:	713-790-0249

Authorized Official
Title or Position	:	SECRETARY
Name	:	MS. TARA TOWNLEY
Credential	:
Telephone Number	:	713-790-9000

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “TEXAS INSTITUTE OF PLASTIC SURGERY ” Practice Location

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