Individual provider Active NPI

Bryan J Correa, M.D.

  • Plastic Surgery Physician
  • The Woodlands, TX
National Provider Identifier
1306085535
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
P5056 Issued in TX
Practice address
4850 W Panther Creek Dr
#105
The Woodlands, TX 77381-3607
Phone
(832) 779-2778
Fax
(832) 403-2201
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X P5056 TX
Plastic Surgery Physician 208200000X P5056 TX Primary

Addresses

Primary practice location

4850 W Panther Creek Dr
#105
The Woodlands, TX 77381-3607

Mailing address

1723 Tuam St
Houston, TX 77004-1252
Phone (832) 779-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916001624 TX Practitioner - Plastic and Reconstructive Surgery 4082833504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Correa Plastic Surgery PLLCGroup PAC ID 3173742699, 2 clinicians

Practice addresses (Care Compare)

4850 W Panther Creek Dr
Suite 105
The Woodlands, TX 77381-3595
Phone (281) 419-9119

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy17
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P5056TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Correa Plastic Surgery PLLC Plastic Surgery CurrentSince Jun 24, 2014 Accepting new patients
Gordley Plastic Surgery PA Plastic and Reconstructive Surgery PastSince Jun 24, 2014 Accepting new patients
Caroline Clarke MD PLLC Plastic and Reconstructive Surgery Past Accepting new patients

Locations

134 Vision Park Blvd
Ste 150
Shenandoah, TX 77384
Phone (346) 202-4660

4850 W Panther Creek Dr
Ste 105
The Woodlands, TX 77381
Phone (281) 419-9119

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1306085535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 TUAM ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041252",
            "telephone_number": "832-779-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W PANTHER CREEK DR",
            "address_2": "#105",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773813607",
            "telephone_number": "832-779-2778",
            "fax_number": "832-403-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "BRYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "P5056",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "P5056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.