Provider Demographics
NPI:1922369503
Name:PEZESHK, RONNIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:A
Last Name:PEZESHK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CTR
Mailing Address - Street 2:DEPARTMENT OF PLASTIC SURGERY 1801 INWOOD ROAD
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9132
Mailing Address - Country:US
Mailing Address - Phone:214-648-8602
Mailing Address - Fax:214-648-2550
Practice Address - Street 1:UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CTR
Practice Address - Street 2:DEPARTMENT OF PLASTIC SURGERY 1801 INWOOD ROAD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9132
Practice Address - Country:US
Practice Address - Phone:214-648-8602
Practice Address - Fax:214-648-2550
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2016-01-22
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Provider Licenses
StateLicense IDTaxonomies
TXQ26042086S0122X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery