Provider Demographics
NPI:1649709452
Name:GUSTE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC
Entity type:Organization
Organization Name:GUSTE PLASTIC AND RECONSTRUCTIVE SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-455-1000
Mailing Address - Street 1:3900 VETERANS BLVD.,
Mailing Address - Street 2:SUITE 200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-455-1000
Mailing Address - Fax:504-455-1555
Practice Address - Street 1:3900 VETERANS BLVD.,
Practice Address - Street 2:SUITE 200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-455-1000
Practice Address - Fax:504-455-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty