Provider Demographics
NPI:1831244375
Name:BOPP DERMATOLOGY AND FACIAL PLASTIC SURGERY
Entity type:Organization
Organization Name:BOPP DERMATOLOGY AND FACIAL PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUELYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:RESENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-455-9933
Mailing Address - Street 1:3421 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3733
Mailing Address - Country:US
Mailing Address - Phone:504-455-9933
Mailing Address - Fax:504-888-8221
Practice Address - Street 1:3421 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3733
Practice Address - Country:US
Practice Address - Phone:504-455-9933
Practice Address - Fax:504-888-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5D428Medicare ID - Type Unspecified