DR. BAO LONG PHAN (NPI# 1083787048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083787048 |
| Entity Type | Individual |
| Full Name | DR. BAO LONG PHAN |
| Credential | M.D. |
| Practice Address |
330 Municipal Dr Suite 104 Richardson TX 75080-3651 |
| Practice Telephone | 9726716398 |
| Practice Fax Number | 9722356419 |
| Mailing Telephone | 9726716398 |
| Mailing Fax Number | 9722356419 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | A61602 | CA | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | 13456 | HI | Allopathic & Osteopathic Physicians |
| Y | 208200000X | Plastic Surgery | L4198 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215597042 | Bao Phan | Pharmacist | 1538 E Chapman Ave, Orange, CA 92866-2231 | 2019-06-14 |
| 1982019618 | Bao Phan | Optometrist | 2053 Wp Ball Blvd, Sanford, FL 32771 | 2014-06-20 |
| Street Address |
330 MUNICIPAL DR SUITE 104 |
| City | RICHARDSON |
| State | TX |
| Zip Code | 75080-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508914011 | Jeffrey Scott Lide | Dentist | 330 Municipal Dr, Ste 100, Richardson, TX 75080-3541 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684717 | Ragan Jones Morales | Counselor | 1702 Gateway Blvd, Suite 349, Richardson, TX 75080 | 2020-09-23 |
| 1316556996 | Medex Diagnostic Services | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 811 South Central Expressway, Suite #516, Richardson, TX 75080 | 2020-07-29 |
| 1083109342 | Amy Viloria | Occupational Therapy Assistant | 417 W Arapaho Rd, Richardson, TX 75080 | 2018-06-28 |
| 1194228437 | Lesley Ellsworth Hall | Counselor | Thrive Clinical & Natural Therapeutics, Pllc, 2007 N. Collins Suite 301, Richardson, TX 75080 | 2018-03-13 |
| 1538686233 | Apex Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1701 N Collins Blvd Ste 230, Richardson, TX 75080 | 2017-08-24 |
| 1326565292 | Go Operations 6 LLC | Skilled Nursing Facility | 1610 Richardson Drive, Richardson, TX 75080 | 2017-08-23 |
| 1093231649 | Twitches Iom Pllc | Electrodiagnostic Medicine | 3400 Waterview Parkway, Suite 305, Richardson, TX 75080 | 2017-08-16 |
| 1639690340 | Faith Mbarathi | Technician, Other | 1702 North Collins Blvd, Suite 250, Richrdson, TX 75080 | 2017-07-03 |
| 1063933083 | Drew Marie Harvick | Technician, Other | 1702 North Collins Blvd Suite 250, Richardson, TX 75080 | 2017-06-29 |
| 1114447026 | Brenda Marie Fitzgerald | Massage Therapist | 100 S. Central Expressway, #43, Richardson, TX 75080 | 2017-06-21 |
| Find all providers in zip 75080 | ||||
| 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 |
|---|---|---|---|---|
| 1437471257 | Chirag V Mehta | Plastic Surgery | 3201 E President George Bush Hwy Ste 101, Richardson, TX 75082 | 2010-02-21 |
| 1376704346 | Derek Alexandre Rapp | Plastic Surgery | 3201 George Bush Hwy, Suite 101, Richardson, TX 75082-3566 | 2008-06-22 |
| 1457471476 | Robert J Schwartz | Plastic Surgery | 375 Municipal Dr, Suite 232, Richardson, TX 75080-3559 | 2007-03-31 |
| 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 | ||||
| City | RICHARDSON |
| Zip Code | 75080 |
Please comment or provide details below to improve the information on DR. BAO LONG PHAN.
| 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.