Southlake Plastic Surgery in Southlake - Oral & Maxillofacial Surgery
Southlake Plastic Surgery - NPI 1255519344
Southlake Plastic Surgery is a Oral & Maxillofacial Surgery in Southlake, Texas. Southlake Plastic Surgery practices all healthcare services and medical treatments related to Oral & Maxillofacial Surgery. The NPI Number for Southlake Plastic Surgery is 1255519344. The last update date is 2008-01-31.
Southlake Plastic Surgery's current location address is 900 E Southlake Blvd, Southlake, Texas. You can contact this provider via phone number 8174428900 and fax number 8174882490. The mailing address for Southlake Plastic Surgery is 900 E Southlake Blvd, Southlake, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southlake Plastic Surgery |
|---|---|
| Address | 900 E Southlake Blvd, Southlake, Texas |
| Phone Number | 8174428900 |
| Fax Number | 8174882490 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Mason E Mark |
| Credentials | MD |
| Telephone Number | 8174428900 |
NPI Number Detail
| NPI Number | 1255519344 |
|---|---|
| Provider Enumeration Date | 2008-01-31 |
| Last Updated Date | 2008-01-31 |
Provider Mailing Address Detail
| Address | 900 E Southlake Blvd |
|---|---|
| City | Southlake |
| State | Texas (TX) |
| Post Code | 760926375 |
| Phone Number | 8174428900 |
| Fax Number | 8174882490 |
Provider's Primary Taxonomy Detail
| Speciality | Oral & Maxillofacial Surgery |
|---|---|
| Taxonomy | 204E00000X |
| Licence No | J4330 |
|
Definition: Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0037EM | TX | BCBSTX GRP NUMBER |
Post Comment/ Review Below
What is the Southlake Plastic Surgery's unique identification number?
The Southlake Plastic Surgery has been assigned the NPI (National Provider Identifier) Number 1255519344 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Southlake Plastic Surgery located?
The Southlake Plastic Surgery is located at 900 E Southlake Blvd, Southlake, TX 760926375.
What is the Southlake Plastic Surgery's area of specialization and corresponding taxonomy classification?
The Southlake Plastic Surgery's specialty field is Oral & Maxillofacial Surgery, and it falls under the taxonomy code 204E00000X, which categorizes healthcare providers based on their specialties.
On what date did Southlake Plastic Surgery receive its 1255519344 assignment from the Centers for Medicare & Medicaid Services?
The Southlake Plastic Surgery was assigned its 1255519344 on 2008-01-31, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Southlake Plastic Surgery last refreshed?
The information related to the Southlake Plastic Surgery, including its address, specialty, and other relevant details, was last updated on 2008-01-31.
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