Texoma Plastic Surgery, P.a.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

L2679 Issued in TX

Legal business name

TEXOMA PLASTIC SURGERY, P.A.

Practice address

2200 Kell Blvd
Wichita Falls, TX 76309-4401

Phone

(940) 264-2600

Fax

(940) 264-2601

NPI assigned

May 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Phillip J Stephan, MDNPI 1053387399

Title

Principle

Phone

(214) 415-6320

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip John Stephan, M.D.

  • Plastic Surgery Physician
  • Wichita Falls, TX
  • NPI 1053387399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1578882809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763071011",
            "telephone_number": "214-522-0210",
            "fax_number": "214-522-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094401",
            "telephone_number": "940-264-2600",
            "fax_number": "940-264-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXOMA PLASTIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "STEPHAN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "214-415-6320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "L2679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texoma Mental Health Associates Inc
• Texoma Mobile Physical Therapy LLC
• Texoma Outpatient Surgery Center, Inc.
• Texoma Outpatient Surgery Center, Inc.
• Texoma Picc Stat
• Texoma Primary Care Clinic
• Texoma Rehab PLLC
• Texoma Rheumatology PLLC
• Texoma Specialty Care
• Texoma Surgery Center LLC

• Plastic Surgery Physician in Wichita Falls, TX
• Providers in Wichita Falls, 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 Mar 5, 2014; 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.