Provider Demographics
NPI:1861560880
Name:THE AESTHETIC CENTER FOR PLASTIC SURGERY, LLP
Entity type:Organization
Organization Name:THE AESTHETIC CENTER FOR PLASTIC SURGERY, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:713-799-9999
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-799-9999
Mailing Address - Fax:713-722-8998
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-799-9999
Practice Address - Fax:713-722-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID
TX=========OtherTAX ID