Provider Demographics
NPI:1801052519
Name:RECONSTRUCTIVE SURGERY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:RECONSTRUCTIVE SURGERY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-207-0650
Mailing Address - Street 1:1140 WESTMONT DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4363
Mailing Address - Country:US
Mailing Address - Phone:281-207-0650
Mailing Address - Fax:
Practice Address - Street 1:1140 WESTMONT DR
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-4363
Practice Address - Country:US
Practice Address - Phone:281-207-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH85932086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty