Provider Demographics
NPI:1700935327
Name:THE CENTER FOR BREAST AND BODY CONTOURING, P.A.
Entity Type:Organization
Organization Name:THE CENTER FOR BREAST AND BODY CONTOURING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-6200
Mailing Address - Street 1:5575 WARREN PKWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4062
Mailing Address - Country:US
Mailing Address - Phone:214-618-4000
Mailing Address - Fax:214-618-6203
Practice Address - Street 1:5575 WARREN PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4062
Practice Address - Country:US
Practice Address - Phone:214-618-4000
Practice Address - Fax:214-618-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2831174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00526YMedicare ID - Type UnspecifiedMCARE GROUP NUMBER