Provider Demographics
NPI:1811350614
Name:DFW FACIAL SURGICAL PARNTERS LLC
Entity type:Organization
Organization Name:DFW FACIAL SURGICAL PARNTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-914-9150
Mailing Address - Street 1:5824 W PLANO PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4697
Mailing Address - Country:US
Mailing Address - Phone:310-914-9150
Mailing Address - Fax:310-914-9705
Practice Address - Street 1:5824 W PLANO PKWY STE 101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4697
Practice Address - Country:US
Practice Address - Phone:310-914-9150
Practice Address - Fax:310-914-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM63941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty