Provider Demographics
NPI:1912291147
Name:ARLINGTON PLASTIC SURGERY, PA
Entity Type:Organization
Organization Name:ARLINGTON PLASTIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SON
Authorized Official - Middle Name:XUAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-468-7000
Mailing Address - Street 1:400 W ARBROOK BLVD
Mailing Address - Street 2:SUITE 331
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3174
Mailing Address - Country:US
Mailing Address - Phone:817-468-7000
Mailing Address - Fax:817-468-7003
Practice Address - Street 1:400 W ARBROOK BLVD
Practice Address - Street 2:SUITE 331
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3174
Practice Address - Country:US
Practice Address - Phone:817-468-7000
Practice Address - Fax:817-468-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0041WQOtherBCBS GROUP #