Provider Demographics
NPI:1164591582
Name:DALLAS ESTHETICS, PLLC
Entity Type:Organization
Organization Name:DALLAS ESTHETICS, PLLC
Other - Org Name:FRANK L HIGGINBOTTOM DDS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIGGINBOTTOM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-827-1150
Mailing Address - Street 1:8201 PRESTON ROAD
Mailing Address - Street 2:SUITE 750
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-827-1150
Mailing Address - Fax:214-823-1370
Practice Address - Street 1:8201 PRESTON ROAD
Practice Address - Street 2:SUITE 75
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-1811
Practice Address - Country:US
Practice Address - Phone:214-827-1150
Practice Address - Fax:214-823-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95911223G0001X
TX208711223G0001X
TX248811223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty