Provider Demographics
NPI:1609168962
Name:CENTRAL TEXAS INSTITUTE OF PLASTIC SURGERY, PA
Entity Type:Organization
Organization Name:CENTRAL TEXAS INSTITUTE OF PLASTIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-752-2575
Mailing Address - Street 1:2201 W LOOP 340
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6856
Mailing Address - Country:US
Mailing Address - Phone:254-752-2575
Mailing Address - Fax:254-752-0188
Practice Address - Street 1:2201 W LOOP 340
Practice Address - Street 2:SUITE 200
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6856
Practice Address - Country:US
Practice Address - Phone:254-752-2575
Practice Address - Fax:254-752-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM93422086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty