Provider Demographics
NPI:1467989822
Name:DAUWE PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:DAUWE PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:DAUWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-6580
Mailing Address - Street 1:2801 LEMMON AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-0355
Mailing Address - Country:US
Mailing Address - Phone:214-821-6580
Mailing Address - Fax:214-821-6584
Practice Address - Street 1:2801 LEMMON AVE STE 310
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-0355
Practice Address - Country:US
Practice Address - Phone:214-821-6580
Practice Address - Fax:214-821-6584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4744208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty