Provider Demographics
NPI:1619292166
Name:FACIAL & OCULOPLASTIC SURGERY CENTER OF TEXAS, PLLC
Entity Type:Organization
Organization Name:FACIAL & OCULOPLASTIC SURGERY CENTER OF TEXAS, PLLC
Other - Org Name:EYEPLASTX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEBACKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-495-2367
Mailing Address - Street 1:PO BOX 797978
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-7978
Mailing Address - Country:US
Mailing Address - Phone:210-495-2367
Mailing Address - Fax:210-495-0155
Practice Address - Street 1:1314 E SONTERRA BLVD
Practice Address - Street 2:SUITE 5104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4278
Practice Address - Country:US
Practice Address - Phone:210-495-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-27
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty