Cosmetic Image Laser Solution, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G6479 Issued in TX

Legal business name

COSMETIC IMAGE LASER SOLUTION, LLC

Doing business as

Creative Image Laser Solution

Practice address

3661 Hwy 377 South
Brownwood, TX 76801-5900

Phone

(325) 642-4014

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gary N Butka, M.D.NPI 1871581272

Title

Owner

Phone

(325) 642-4014

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Creative Image Laser Solution Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Gary N Butka, M.D.

  • Internal Medicine Physician
  • Brownwood, TX
  • NPI 1871581272
  Medicare reassignment NPD Authorized official
• John William Hays, MD

  • Diagnostic Radiology Physician
  • Brownwood, TX
  • NPI 1083666549
  NPD (past)
• Kimberley Strong, FNP

  • Nurse Practitioner
  • Brownwood, TX
  • NPI 1013958487
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1760664650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 HWY 377 SOUTH",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015900",
            "telephone_number": "325-642-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 HWY 377 SOUTH",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015900",
            "telephone_number": "325-642-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC IMAGE LASER SOLUTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "BUTKA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-642-4014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G6479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "G6479",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Image Laser Solution",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Comolli & Ethridge
• Kent Collier Comolli, OD
• Kayla Ann Conley, PT, DPT
• Charles Gregory Cooper Jr., P.A.
• Coryell County Memorial Hospital Authority
• Chad Emery Coulter, CRNA
• Angela D Cox, P.T.
• Christina Lynne Cox, LPC ASSOCIATE
• Tamara M Cox, M.D.
• CRB Medical Associates

• Internal Medicine Physician in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.