Provider Demographics
NPI:1134516404
Name:PLANO TEXAS PLASTIC SURGERY CENTER
Entity Type:Organization
Organization Name:PLANO TEXAS PLASTIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:O
Authorized Official - Last Name:ANGOBALDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:972-378-3870
Mailing Address - Street 1:5880 ASHMILL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0033
Mailing Address - Country:US
Mailing Address - Phone:972-378-3870
Mailing Address - Fax:972-378-7977
Practice Address - Street 1:5880 ASHMILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0033
Practice Address - Country:US
Practice Address - Phone:972-378-3870
Practice Address - Fax:972-378-7977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JRDES LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical