Keystone Plastic Reconstructive Surgery,LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

KEYSTONE PLASTIC RECONSTRUCTIVE SURGERY,LLC

Practice address

3115 College Park Dr
Suite 101
The Woodlands, TX 77384-4000

Phone

(936) 321-4345

Fax

(936) 321-4353

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Thomas O Shannon, MD

Title

General Manager

Phone

(936) 321-4345

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1598977290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR",
            "address_2": "SUITE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844000",
            "telephone_number": "936-321-4345",
            "fax_number": "936-321-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR",
            "address_2": "SUITE 101",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844000",
            "telephone_number": "936-321-4345",
            "fax_number": "936-321-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PLASTIC RECONSTRUCTIVE SURGERY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "936-321-4345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080725701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin M Moran MD PA
• Tana G. Key, O.T.
• Keyes to Health PLLC
• Kevin John Keyes, DC
• Keystone Outpatient Services, LLC
• Keystone Surgicenter LLC
• Tara Khadem, LPC, CGP
• Ajmal Aaqib Khalid, DMD
• Salwa T Khalil, RPH
• Hina Nasir Khan, M.D.

• Plastic and Reconstructive Surgery Physician in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.