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NPI Code Detail

MEDICARE: AESTHETIC AND RECONSTRUCTIVE THERAPEUTICS PLLC

MEDICARE: AESTHETIC AND RECONSTRUCTIVE THERAPEUTICS PLLC
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
1208200000XPlastic Surgery Physician
22086S0122XPlastic and Reconstructive Surgery PhysicianP6546TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952786212
Entity Type Code : Organization
Provider Name (Legal Business Name) : AESTHETIC AND RECONSTRUCTIVE THERAPEUTICS PLLC
Provider Business Mailing Address
First Line : 1101 W 34TH ST # 304
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1907
Country : US
Telephone Number : 512-815-0123
Fax Number : 512-861-6206
Provider Business Practice Location Address
First Line : 2905 SAN GABRIEL ST STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78705-3548
Country : US
Telephone Number : 512-815-0123
Fax Number : 512-763-4546
Authorized Official
Title or Position : OWNER
Name : CHRISTINE FISHER
Credential : M.D.
Telephone Number : 512-815-0123
Provider Enumeration Date : 07/28/2015
Last Update Date : 02/22/2026

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Directions to “AESTHETIC AND RECONSTRUCTIVE THERAPEUTICS PLLC ” Practice Location

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