Provider Demographics
NPI:1427252345
Name:THE ARTISAN CENTER FOR PLASTIC SURGERY
Entity type:Organization
Organization Name:THE ARTISAN CENTER FOR PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGERON
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:281-578-7600
Mailing Address - Street 1:24022 CINCO VILLAGE CENTER BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8397
Mailing Address - Country:US
Mailing Address - Phone:281-578-7600
Mailing Address - Fax:281-578-7600
Practice Address - Street 1:24022 CINCO VILLAGE CENTER BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8397
Practice Address - Country:US
Practice Address - Phone:281-578-7600
Practice Address - Fax:281-578-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6364174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6993Medicare PIN