Provider Demographics
NPI:1750508495
Name:RENAISSANCE PLASTIC SURGERY
Entity Type:Organization
Organization Name:RENAISSANCE PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NARSETE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:372-378-3870
Mailing Address - Street 1:6105 WINDCOM CT
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7889
Mailing Address - Country:US
Mailing Address - Phone:972-378-3870
Mailing Address - Fax:972-378-7977
Practice Address - Street 1:6105 WINDCOM CT
Practice Address - Street 2:SUITE 150
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-378-3870
Practice Address - Fax:972-378-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL34092086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC97996Medicare UPIN