Westside Plastic Surgery, PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

WESTSIDE PLASTIC SURGERY, PLLC

Practice address

3416 Lovell Ave Ste 110
Fort Worth, TX 76107-5718

Phone

(817) 961-1950

Fax

(817) 887-3105

NPI assigned

Jan 6, 2023

Organization subpart

No

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

Authorized official

Name

Dolores Wallace

Title

Office Manager

Phone

(817) 961-1950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1730893645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 LOVELL AVE STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075718",
            "telephone_number": "817-961-1950",
            "fax_number": "817-887-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 LOVELL AVE STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075718",
            "telephone_number": "817-961-1950",
            "fax_number": "817-887-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-961-1950"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westlake Health & Beauty Products (Westlake Health Mart Pharmacy)
• Dana Weston, RDH, IBCLC
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• Westside Caregivers, LLC
• Westside Concierge Physical Therapy
• Westside Spine and Rehab
• Westview Dentistry PLLC
• Linda Westwood, LCDC
• Liberty B Wethington, CP
• James Patrick Wharry, D.D.S.

• Plastic Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, 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 6, 2023; 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.