Active NPI
Sule Facial Plastic Surgery Clinic,P.a.
- Facial Plastic Surgery Physician
- Dallas, TX
National Provider Identifier
1164699237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- M4570
- Legal business name
- SULE FACIAL PLASTIC SURGERY CLINIC,P.A.
- Practice address
- 12221 Merit Dr
Suite 1060
Dallas, TX 75251-2202 - Phone
- (972) 960-2950
- Fax
- (972) 960-2838
- NPI assigned
- May 8, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sandeep Sule, M.D.
- Title
- President
- Phone
- (972) 960-2950
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | M4570 | TX | Primary |
Addresses
Primary practice location
12221 Merit Dr
Suite 1060
Dallas, TX 75251-2202
Mailing address
12221 Merit Dr
Suite 1060
Dallas, TX 75251-2202
Phone (972) 960-2950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080716000274 | TX | Part B Supplier - Clinic/Group Practice | 0547333114 |
Receives reassigned benefits from 1 practitioner Practice locations: Dallas, TX |
National Provider Directory
National Provider DirectoryLocations
12221 Merit Dr
Ste 1060
Dallas, TX 75251
Phone (972) 960-2950
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210204800000",
"number": "1164699237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12221 MERIT DR",
"address_2": "SUITE 1060",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512202",
"telephone_number": "972-960-2950",
"fax_number": "972-960-2838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12221 MERIT DR",
"address_2": "SUITE 1060",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512202",
"telephone_number": "972-960-2950",
"fax_number": "972-960-2838"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SULE FACIAL PLASTIC SURGERY CLINIC,P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-08",
"last_updated": "2008-05-08",
"status": "A",
"authorized_official_last_name": "SULE",
"authorized_official_first_name": "SANDEEP",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "972-960-2950",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "TX",
"license": "M4570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.