SOUTHLAKE PLASTIC SURGERY (NPI# 1255519344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255519344 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE PLASTIC SURGERY |
| Practice Address |
900 E Southlake Blvd Ste 100 Southlake TX 76092-6375 |
| Practice Telephone | 8174428900 |
| Practice Fax Number | 8174882490 |
| Mailing Telephone | 8174428900 |
| Mailing Fax Number | 8174882490 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |
| Authorized Official Name | MARK E MASON (OWNER) |
| Authorized Official Telephone | 8174428900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | J4330 | TX | Allopathic & Osteopathic Physicians |
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBSTX GRP NUMBER | 0037EM | 01 |
| Street Address |
900 E SOUTHLAKE BLVD STE 100 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-6375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568545739 | Texas Regional Asthma & Allergy Center | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2006-10-23 |
| 1144789934 | Caitlin Elizabeth Pedigo | Registered Nurse | 900 E Southlake Blvd, Southlake, TX 76092-6375 | 2019-03-19 |
| 1346646528 | Destination Health | Family Medicine | 900 E Southlake Blvd, Suite 200, Southlake, TX 76092-6375 | 2014-11-14 |
| 1922329465 | Sharon Seth | Allergy & Immunology | 900 E Southlake Blvd, Suite 300, Southlake, TX 76092-6375 | 2010-06-18 |
| 1366652208 | Alireza Allen Shakouri | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2007-05-22 |
| 1285787085 | Robin Annette Hall | Family Medicine | 900 E Southlake Blvd, Suite 200, Southlake, TX 76092-6375 | 2007-01-18 |
| 1639255896 | Rene Albert Leon | Specialist | 900 E Southlake Blvd, Ste 300, Southlake, TX 76092-6375 | 2006-10-31 |
| 1255414272 | Mark E Mason | Oral & Maxillofacial Surgery | 900 E Southlake Blvd, Ste 100, Southlake, TX 76092-6375 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013993203 | Scott Edward Kasden | Plastic Surgery | 2813 W Southlake Blvd Suite 130, Suite 130, Southlake, TX 76092-6829 | 2005-12-19 |
| 1134463474 | Habash Md | Plastic Surgery | 1100 E Southlake Blvd, Suite 250, Southlake, TX 76092-6357 | 2012-11-26 |
| 1831335702 | Michael A. Bogdan, Md, Pllc | Plastic Surgery | 410 N Carroll Ave, Suite 170, Southlake, TX 76092-6455 | 2008-12-26 |
| 1053506923 | North Texas Plastic Surgery | Plastic Surgery | 1545 E Southlake Blvd, Suite 250, Southlake, TX 76092-6422 | 2007-09-13 |
| 1295941169 | Sacha Imran Obaid | Plastic Surgery | 1545 E Southlake Blvd, Suite 250, Southlake, TX 76092-6422 | 2007-05-15 |
| 1952498826 | Ameen Habash | Plastic Surgery | 1422 Main St, Suite 274, Southlake, TX 76092-7625 | 2006-10-10 |
| 1881629103 | Michael A Bogdan | Plastic Surgery | 410 N Carroll Ave, Suite 170, Southlake, TX 76092-6455 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467059063 | Joseph Peter Corkum | Plastic Surgery | 1400 Pressler St Unit 1488, Houston, TX 77030-3722 | 2020-10-06 |
| 1780212829 | Kendall R Roehl Md Pllc | Plastic Surgery | 450 W Medical Center Blvd Ste 202, Webster, TX 77598-4229 | 2020-04-01 |
| 1275184871 | Dallas Premier Plastic Surgery, P.l.l.c. | Plastic Surgery | 8144 Walnut Hill Ln Ste 901, Dallas, TX 75231-4386 | 2019-09-25 |
| 1447802798 | Michael Ciaravino, Md Pa | Plastic Surgery | 3700 Buffalo Speedway Ste 850, Houston, TX 77098-3705 | 2019-07-16 |
| 1437617255 | Westlake Dermatology, Pa | Plastic Surgery | 2132 Bissonnet St, Houston, TX 77005-1508 | 2019-03-11 |
| 1528530326 | Peter George Dziewulski | Plastic Surgery | Utmb 301 University Boulevard 6.146 John Sealy Annex, Galveston, TX 77555-0001 | 2018-12-19 |
| 1225504491 | Beleza Surgery Center LLC | Plastic Surgery | 9899 Towne Lake Pkwy Ste 200, Cypress, TX 77433-6838 | 2018-10-15 |
| 1104311901 | Zeynep Deniz Akdeniz Dogan | Plastic Surgery | 1400 Pressler St The University of Texas Md Anderson Ca, Unit 1488, Houston, TX 77030 | 2018-06-25 |
| 1730604992 | Sarah A Frommer Medical Pllc | Plastic Surgery | 11412 Bee Caves Rd Ste 300, Austin, TX 78738-5515 | 2017-08-09 |
| 1992220180 | Johnny U. Franco, Md, Pa | Plastic Surgery | 3445 Executive Center Dr Ste 213, Austin, TX 78731-1743 | 2017-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.