PEDIATRIC PLASTIC SURGERY (NPI# 1154470557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154470557 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC PLASTIC SURGERY |
| Other Organization Name | INTERNATIONAL CRANIOFACIAL INSTITUTE |
| Practice Address |
7777 Forest Ln Suite C717 Dallas TX 75230-2505 |
| Mailing Address |
6757 Arapaho Rd Suite 725 Dallas TX 75248-4005 |
| Practice Telephone | 9725666555 |
| Practice Fax Number | 9725666017 |
| Mailing Telephone | 9725666555 |
| Mailing Fax Number | 9725666017 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JULI MANN (OFFICE MANAGER) |
| Authorized Official Telephone | 9725666555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
NOT APPLICABLE | TX | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| International Craniofacial Institute | Doing Business As Name - Organization |
| Street Address |
7777 FOREST LN SUITE C717 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546101 | Frederick J Duffy Jr. | Plastic Surgery | 7777 Forest Ln, Ste C504, Dallas, TX 75230 | 2005-05-24 |
| 1710586870 | Dessy Santika Adont | Nurse Practitioner | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-10-20 |
| 1003433913 | Kasey Rehme | Speech-Language Pathologist | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-06-26 |
| 1083230015 | Abigail Anne Plec | Physician Assistant | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-06-25 |
| 1225650500 | Minh Nguyen | Pharmacist | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-05-10 |
| 1578184297 | Hk Anesthesia Services Pllc | Anesthesiology | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-05-05 |
| 1225657018 | Kristina Marie George | Nurse Practitioner | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-04-11 |
| 1376176024 | Carla Patricia Jimenez Santillan | Nurse Practitioner | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-02-20 |
| 1508496795 | Kafayat Oritola | Nurse Practitioner | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-01-16 |
| 1699315630 | Rachel Kimberly Harris | Occupational Therapist | 7777 Forest Ln, Dallas, TX 75230-2571 | 2020-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, 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. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821577859 | Taylor Siemens | Plastic Surgery | 17311 Dallas Pkwy Ste 100, Dallas, TX 75248-1149 | 2018-08-10 |
| 1649520917 | Samer Abou Zeid | Plastic Surgery | 3700 Cole Avenue, Apt#405, Dallas, TX 75204-4543 | 2012-09-14 |
| 1871608869 | G. Hunt Neurohr, M.d., P.a. | Plastic Surgery | 6120 Sherry Ln, Dallas, TX 75225-6301 | 2006-08-20 |
| 1801813563 | Abraham Armani | Plastic Surgery | 2928 Oak Lawn Ave, Dallas, TX 75219 | 2006-07-17 |
| 1093379810 | Earwell Centers of Excellence, Pllc | Plastic Surgery | 9101 N Central Expy Ste 595, Dallas, TX 75231-6080 | 2019-04-26 |
| 1871017913 | Dallas Plastic Surgery Institute Management, Pa | Plastic Surgery | 9101 N Central Expy Ste 600, Dallas, TX 75231-5956 | 2017-07-31 |
| 1265963854 | Earwell Centers of Texas | Plastic Surgery | 9101 N Central Expy, Ste 600, Dallas, TX 75231-5927 | 2017-03-24 |
| 1568666493 | Evan W. Beale | Plastic Surgery | 7777 Forest Ln, Suite B116, Dallas, TX 75230-2571 | 2007-06-13 |
| 1992708721 | Texas Center for Breast Reconstruction | Plastic Surgery | 7777 Forest Ln, Ste C504, Dallas, TX 75230 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659825602 | Craniofacial Team of Texas Partners | Plastic Surgery | 11412 Bee Cave Road Ste 300, Austin, TX 78738 | 2016-08-08 |
| 1629445820 | Kenneth C.y. Yu, Md, Pa | Plastic Surgery | 19288 Stone Oak Pkwy Ste A, San Antonio, TX 78258-3222 | 2015-08-24 |
| 1922323443 | Eric Scott Rosenberger | Plastic Surgery | 10815 Rr 2222 Bldg 3c, Ste. 101, Austin, TX 78730-1159 | 2010-03-29 |
| 1891921318 | Steven L Crawshaw | Plastic Surgery | 5333 Westheimer Rd, Suite 560, Houston, TX 77056-5411 | 2009-06-10 |
| 1982827366 | Bernardino Antonio Arocha | Plastic Surgery | 3005 Huldy St, Houston, TX 77098-2709 | 2007-04-11 |
| 1134175276 | Azul S Jaffer | Plastic Surgery | 6914 Brisbane Court, Suite 300, Sugar Land, TX 77479 | 2006-05-26 |
| 1154319598 | Sean Boutros | Plastic Surgery | 9230 Katy Fwy Ste 600, Houston, TX 77055-7468 | 2005-10-10 |
| 1265899884 | Donald A. Hollsten, M.d. | Plastic Surgery | 7950 Floyd Curl Dr, Suite 702, San Antonio, TX 78229-3919 | 2016-01-27 |
| 1487082590 | Oral and Facial Cosmetic Surgery Pa | Plastic Surgery | 2450 Fondren Rd Ste 130, Houston, TX 77063-2398 | 2013-10-29 |
| 1295027183 | Boutros Surgical Associates Pa | Plastic Surgery | 6400 Fannin St Ste 2290, Houston, TX 77030-1543 | 2011-05-10 |
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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.