Provider Demographics
NPI:1447458690
Name:FACE-FACIAL CENTER FOR PLASTIC SURGERY
Entity type:Organization
Organization Name:FACE-FACIAL CENTER FOR PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:832-358-3223
Mailing Address - Street 1:7700 SAN FELIPE ST STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1614
Mailing Address - Country:US
Mailing Address - Phone:832-358-3223
Mailing Address - Fax:832-358-3220
Practice Address - Street 1:7700 SAN FELIPE ST STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1614
Practice Address - Country:US
Practice Address - Phone:832-358-3223
Practice Address - Fax:832-358-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2685Medicare UPIN