Aesthetic Laser & Surgery Facility

Key facts

NPI: 1841361052
Entity type: Organization (NPI type 2)
Primary specialty: Ambulatory Surgical Clinic/Center 261QA1903X
License: 136-113 (GA)
Legal business name: AESTHETIC LASER & SURGERY FACILITY
Practice address: 416 Gordon Ave
Thomasville, GA 31792-6644
Phone: (229) 228-7200
Fax: (229) 228-5193
NPI assigned: Nov 10, 2006
Organization subpart: No

Authorized official

Name: Dr. G. Courtney Houston, M.D. NPI 1295805570
Title: Medical Director
Phone: (229) 228-7200

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

G. Courtney Houston, M.D. Plastic and Reconstructive Surgery Physician · Thomasville, GA · NPI 1295805570

NPD (past) Authorized official

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ambulatory Surgical Clinic/Center	261QA1903X	136-113	GA	Yes

Addresses

Primary practice location

416 Gordon Ave
Thomasville, GA 31792-6644

Mailing address

416 Gordon Ave
Thomasville, GA 31792-6644
Phone (229) 228-7200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841361052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926644",
            "telephone_number": "229-228-7200",
            "fax_number": "229-228-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926644",
            "telephone_number": "229-228-7200",
            "fax_number": "229-228-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC LASER & SURGERY FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "G. COURTNEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "229-228-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "136-113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

All providers in Thomasville, GA · Ambulatory Surgical Clinic/Center in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.