Provider Demographics
NPI:1194993543
Name:PLASTIC SURGERY ASSOCIATES OF DALLAS
Entity type:Organization
Organization Name:PLASTIC SURGERY ASSOCIATES OF DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-7940
Mailing Address - Street 1:6300 W PARKER RD
Mailing Address - Street 2:SUITE 427
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8160
Mailing Address - Country:US
Mailing Address - Phone:972-981-7940
Mailing Address - Fax:972-981-7941
Practice Address - Street 1:6300 W PARKER RD
Practice Address - Street 2:SUITE 427
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8160
Practice Address - Country:US
Practice Address - Phone:972-981-7940
Practice Address - Fax:972-981-7941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613537Medicare PIN