Organization Active NPI

Texas Center for Facial Plastic & Laser Surgery, LLC

  • Facial Plastic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1033624663
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
Legal business name
TEXAS CENTER FOR FACIAL PLASTIC & LASER SURGERY, LLC
Practice address
14603 Huebner Rd Ste 102
San Antonio, TX 78230-5469
Phone
(210) 468-5426
Fax
(210) 468-3282
NPI assigned
Dec 5, 2017
Last updated
Dec 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kellie Hawkins
Title
Credentialing Account Manager
Phone
(210) 298-6847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0123X TX Primary

Addresses

Primary practice location

14603 Huebner Rd Ste 102
San Antonio, TX 78230-5469

Mailing address

14603 Huebner Rd Ste 102
San Antonio, TX 78230-5469
Phone (210) 468-5426

National Provider Directory

National Provider Directory

Locations

14603 Huebner Rd
Ste 102
San Antonio, TX 78230
Phone (210) 468-5426

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1033624663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14603 HUEBNER RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305469",
            "telephone_number": "210-468-5426",
            "fax_number": "210-468-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14603 HUEBNER RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305469",
            "telephone_number": "210-468-5426",
            "fax_number": "210-468-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS CENTER FOR FACIAL PLASTIC & LASER SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CREDENTIALING ACCOUNT MANAGER",
        "authorized_official_telephone_number": "210-298-6847",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.