Provider Demographics
NPI:1164112108
Name:BEAUTYBLADE PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:BEAUTYBLADE PLASTIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-521-4342
Mailing Address - Street 1:3333 S BANNOCK ST STE 150
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2514
Mailing Address - Country:US
Mailing Address - Phone:720-677-5649
Mailing Address - Fax:720-647-3784
Practice Address - Street 1:3333 S BANNOCK ST STE 150
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2514
Practice Address - Country:US
Practice Address - Phone:720-677-5649
Practice Address - Fax:720-647-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty