Organization Active NPI

Christopher J Micallef DO PLLC

Doing business as Micallef Plastic Surgery

  • Plastic Surgery Physician
  • Shavano Park, TX
National Provider Identifier
1174381792
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
CHRISTOPHER J MICALLEF DO PLLC
Doing business as
Micallef Plastic Surgery
Practice address
4372 N Loop 1604 W Ste 200
Shavano Park, TX 78249-1201
Phone
(726) 206-3484
Fax
(210) 547-0265
NPI assigned
Mar 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Dr. Christopher James Micallef, DONPI 1154557502
Title
Owner
Phone
(937) 830-4249

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)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

4372 N Loop 1604 W Ste 200
Shavano Park, TX 78249-1201

Mailing address

7600 Broadway Apt 4008
San Antonio, TX 78209-1980
Phone (937) 830-4249

Other names 1

  • Micallef Plastic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250730004136 TX Part B Supplier - Clinic/Group Practice 4082121231 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

4372 N Loop 1604 W
Ste 200
Shavano Park, TX 78249
Phone (726) 202-0924

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": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1174381792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 BROADWAY APT 4008",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091980",
            "telephone_number": "937-830-4249",
            "fax_number": "210-547-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4372 N LOOP 1604 W STE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782491201",
            "telephone_number": "726-206-3484",
            "fax_number": "210-547-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER J MICALLEF DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "MICALLEF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-830-4249",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Micallef Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shavano Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.

Verify at the official NPI Registry.