Provider Demographics
NPI:1245407626
Name:TEXAS INSTITUTE OF PLASTIC SURGERY
Entity Type:Organization
Organization Name:TEXAS INSTITUTE OF PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-790-9000
Mailing Address - Street 1:6624 FANNIN ST STE 2200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2334
Mailing Address - Country:US
Mailing Address - Phone:713-790-9000
Mailing Address - Fax:713-790-0249
Practice Address - Street 1:6624 FANNIN ST STE 2200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2334
Practice Address - Country:US
Practice Address - Phone:713-790-9000
Practice Address - Fax:713-790-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty