Organization Active NPI

Surgical Renewal & Aesthetics

  • Plastic Surgery Physician
  • Cedar Park, TX
National Provider Identifier
1174836126
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
N1552 Issued in TX
Legal business name
SURGICAL RENEWAL & AESTHETICS
Practice address
1900 Cypress Creek Rd
Suite 100
Cedar Park, TX 78613-3513
Phone
(512) 535-5554
Fax
(512) 454-5252
NPI assigned
Jul 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Paul Anthony Berry, M.D.NPI 1871738831
Title
President
Phone
(512) 535-5554

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 N1552 TX Primary

Addresses

Primary practice location

1900 Cypress Creek Rd
Suite 100
Cedar Park, TX 78613-3513

Mailing address

1900 Cypress Creek Rd
Suite 100
Cedar Park, TX 78613-3513
Phone (512) 535-5554

National Provider Directory

National Provider Directory

Locations

1900 Cypress Creek Rd
Ste 100
Cedar Park, TX 78613
Phone (512) 535-5554

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": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1174836126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CYPRESS CREEK RD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133513",
            "telephone_number": "512-535-5554",
            "fax_number": "512-454-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CYPRESS CREEK RD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133513",
            "telephone_number": "512-535-5554",
            "fax_number": "512-454-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL RENEWAL & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-535-5554",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "N1552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.