So, TX. Aesthetic Enhancement Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2974 Issued in TX

Legal business name

SO, TX. AESTHETIC ENHANCEMENT CENTER

Practice address

2525 S Shore Blvd Ste 201
League City, TX 77573-2988

Phone

(281) 538-6600

NPI assigned

May 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles George Polsen, M.D.NPI 1801929195

Title

Doctor

Phone

(281) 538-6600

Specialties & licenses 1

Addresses

Other names 1

• S.T.A.E.C. Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Polsen, M.D.

  • Surgery of the Hand (Surgery) Physician
  • Seabrook, TX
  • NPI 1801929195
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841409281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S SHORE BLVD STE 201",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732988",
            "telephone_number": "281-538-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S SHORE BLVD STE 201",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732988",
            "telephone_number": "281-538-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO, TX. AESTHETIC ENHANCEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLSEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "281-538-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "2974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S.T.A.E.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Latanya Denise Smith, APRN, FNP-C
• Mikel Smith
• Myia Smith
• Leah Marie Smythe, PA
• SNG - League City Dialysis LP
• Stephanie Lynn Soares, MA CCC-SLP
• Daneshvari R Solanki, FFARCS
• Ahmed H Soliman, DC
• Zyaad Hesham-Adel Soliman, DC
• South Houston Med Equip LLC

• Ambulatory Surgical Clinic/Center in League City, TX
• Providers in League City, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.