Provider Demographics
NPI:1316170079
Name:COSMETIC FACIAL SOLUTIONS, PLLC
Entity type:Organization
Organization Name:COSMETIC FACIAL SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:972-733-0414
Mailing Address - Street 1:5824 W PLANO PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4697
Mailing Address - Country:US
Mailing Address - Phone:972-733-0414
Mailing Address - Fax:972-733-0567
Practice Address - Street 1:5824 W PLANO PKWY STE 101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4697
Practice Address - Country:US
Practice Address - Phone:972-733-0414
Practice Address - Fax:972-733-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6394261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty