Provider Demographics
NPI:1508050758
Name:D.J. VERRET, MD, PA
Entity Type:Organization
Organization Name:D.J. VERRET, MD, PA
Other - Org Name:INNOVATIONS FACIAL PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VERRET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-608-0100
Mailing Address - Street 1:6545 PRESTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2710
Mailing Address - Country:US
Mailing Address - Phone:972-608-0100
Mailing Address - Fax:
Practice Address - Street 1:6545 PRESTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2710
Practice Address - Country:US
Practice Address - Phone:972-608-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y366Medicare PIN