Provider Demographics
NPI:1184934432
Name:NEOSCULPT LASER VEIN AND COSMETIC SURGERY CENTER PLLC
Entity type:Organization
Organization Name:NEOSCULPT LASER VEIN AND COSMETIC SURGERY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKUNJKUMAR
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-692-8346
Mailing Address - Street 1:2225 S DANVILLE DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4779
Mailing Address - Country:US
Mailing Address - Phone:325-692-8346
Mailing Address - Fax:325-701-7802
Practice Address - Street 1:2225 S DANVILLE DR
Practice Address - Street 2:SUITE #2
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4779
Practice Address - Country:US
Practice Address - Phone:325-692-8346
Practice Address - Fax:325-701-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7099207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty