Provider Demographics
NPI:1669791349
Name:LUXE PLASTIC SURGERY PA
Entity type:Organization
Organization Name:LUXE PLASTIC SURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-313-0551
Mailing Address - Street 1:4660 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3166
Mailing Address - Country:US
Mailing Address - Phone:281-313-0551
Mailing Address - Fax:281-313-0558
Practice Address - Street 1:4660 SWEETWATER BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3166
Practice Address - Country:US
Practice Address - Phone:281-313-0551
Practice Address - Fax:281-313-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3126208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty