Provider Demographics
NPI:1265725873
Name:BANCROFT FELDMAN PLASTIC SURGERY, PLLC
Entity type:Organization
Organization Name:BANCROFT FELDMAN PLASTIC SURGERY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-313-0540
Mailing Address - Street 1:4690 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3467
Mailing Address - Country:US
Mailing Address - Phone:281-313-0540
Mailing Address - Fax:281-313-0542
Practice Address - Street 1:4690 SWEETWATER BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3467
Practice Address - Country:US
Practice Address - Phone:281-313-0540
Practice Address - Fax:281-313-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty