Provider Demographics
NPI:1780129171
Name:LINVILLE AESTHETIC & RECONSTRUCTIVE SURGERY PLLC
Entity type:Organization
Organization Name:LINVILLE AESTHETIC & RECONSTRUCTIVE SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LINVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-0161
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:STE 700C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-795-0161
Mailing Address - Fax:713-795-0155
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:STE 700C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-795-0161
Practice Address - Fax:713-795-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty