Provider Demographics
NPI:1124545660
Name:CILENTO FACIAL PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:CILENTO FACIAL PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:WEST
Authorized Official - Last Name:CILENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-474-2355
Mailing Address - Street 1:63 OLMSTEAD ROW
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2874
Mailing Address - Country:US
Mailing Address - Phone:832-474-2355
Mailing Address - Fax:281-901-5334
Practice Address - Street 1:2940 FARM TO MARKET 2920 RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:346-413-9313
Practice Address - Fax:346-386-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5629207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty