Southlake Plastic Surgery
LBN: Southlake Plastic Surgery
Southlake Plastic Surgery is an health care organization with primary practice located at 900 E Southlake Blvd Ste 100, Southlake TX 76092-6375. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is the primary health care specialty.
Southlake Plastic Surgery can be contacted via phone (817) 442-8900, or through Mason, Mark E via phone (817) 442-8900.
Contact Information
Primary practice address
900 E Southlake Blvd Ste 100
Southlake TX 76092-6375
Phone: (817) 442-8900
Fax: (817) 488-2490
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | J4330 | Texas |
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X |
Profile Details
| NPI number | 1255519344 |
|---|---|
| LBN Legal business name | Southlake Plastic Surgery |
| DBA Doing business as | |
| Authorized official | Mason, Mark E Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 31st, 2008 |
| Last updated | Jan 31st, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255519344 | NPPES |
| Texas | Other | 0037EM | BCBSTX GRP NUMBER |
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