Provider Demographics
NPI:1588636278
Name:AESTHETIC PLASTIC SURGERY CENTER, L.P.
Entity Type:Organization
Organization Name:AESTHETIC PLASTIC SURGERY CENTER, L.P.
Other - Org Name:MD AESTHETIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-528-9100
Mailing Address - Street 1:1200 BINZ ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6900
Mailing Address - Country:US
Mailing Address - Phone:713-528-9100
Mailing Address - Fax:713-528-2115
Practice Address - Street 1:1200 BINZ ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6900
Practice Address - Country:US
Practice Address - Phone:713-528-9100
Practice Address - Fax:713-528-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007855261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC194Medicare ID - Type UnspecifiedCURRENT MEDICARE ID