Provider Demographics
NPI:1467941419
Name:THE OAKS PLASTIC SURGERY
Entity Type:Organization
Organization Name:THE OAKS PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NANDHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIJAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-287-8387
Mailing Address - Street 1:4306 YOAKUM BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5851
Mailing Address - Country:US
Mailing Address - Phone:225-573-0479
Mailing Address - Fax:
Practice Address - Street 1:4306 YOAKUM BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5851
Practice Address - Country:US
Practice Address - Phone:225-573-0479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty