Provider Demographics
NPI:1386237394
Name:SOUTHWEST BREAST AND AESTHETICS, LLC
Entity type:Organization
Organization Name:SOUTHWEST BREAST AND AESTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-420-3561
Mailing Address - Street 1:2801 E CAMELBACK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4363
Mailing Address - Country:US
Mailing Address - Phone:480-576-4310
Mailing Address - Fax:480-576-4311
Practice Address - Street 1:2801 E CAMELBACK RD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4363
Practice Address - Country:US
Practice Address - Phone:480-576-4310
Practice Address - Fax:480-576-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty