Provider Demographics
NPI:1447562780
Name:SUNCOAST PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:SUNCOAST PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SWETANSHU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-385-9928
Mailing Address - Street 1:2521 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6327
Mailing Address - Country:US
Mailing Address - Phone:832-398-0112
Mailing Address - Fax:832-201-0344
Practice Address - Street 1:215 E EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3820
Practice Address - Country:US
Practice Address - Phone:832-398-0112
Practice Address - Fax:832-201-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5616208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB104764Medicare PIN