Provider Demographics
NPI:1518195338
Name:TABBAL, GEORGES NICOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:NICOLAS
Last Name:TABBAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEO
Other - Middle Name:N
Other - Last Name:TABBAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8501 WADE BLVD STE 1485
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0313
Mailing Address - Country:US
Mailing Address - Phone:214-618-3006
Mailing Address - Fax:
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:712-702-1100
Practice Address - Fax:817-702-6839
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277024208200000X
TXQ2397208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery