Southlake Plastic Surgery

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

SOUTHLAKE PLASTIC SURGERY

Practice address

900 E Southlake Blvd
Ste 100
Southlake, TX 76092-6375

Phone

(817) 442-8900

Fax

(817) 488-2490

NPI assigned

Jan 31, 2008

Last updated

Jan 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark E Mason, MDNPI 1255414272

Title

Owner

Phone

(817) 442-8900

Specialties & licenses 2

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Mark E Mason, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Southlake, TX
  • NPI 1255414272
  Authorized official Same address or phone

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1255519344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E SOUTHLAKE BLVD",
            "address_2": "STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926375",
            "telephone_number": "817-442-8900",
            "fax_number": "817-488-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E SOUTHLAKE BLVD",
            "address_2": "STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926375",
            "telephone_number": "817-442-8900",
            "fax_number": "817-488-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-442-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "J4330",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GRP NUMBER",
            "identifier": "0037EM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southlake Mhya PLLC (Medrein Health and Aesthetics)
• Southlake Natural Family Wellness, PLLC
• Southlake Neurology and
• Southlake Oncology
• Southlake Physical Medicine PLLC
• Southlake Psychological Associates, PLLC
• Southlake Serenity Psychiatry
• Southlake Sleep Center, LTD
• Southlake Specialty Hospital, LLC (Texas Health Harris Methodist Hospital Southlake)
• Southlake Sports & Spine Rehab PLLC

• Plastic Surgery Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.