Provider Demographics
NPI:1588918551
Name:PLASTIC SURGERY ASSOCIATES PA
Entity type:Organization
Organization Name:PLASTIC SURGERY ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HABASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-200-8580
Mailing Address - Street 1:8601 CANTERA WAY
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-1133
Mailing Address - Country:US
Mailing Address - Phone:682-200-8580
Mailing Address - Fax:682-200-8581
Practice Address - Street 1:1250 8TH AVE STE 265
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4124
Practice Address - Country:US
Practice Address - Phone:682-200-8580
Practice Address - Fax:682-200-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6334208200000X
2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty