Dermatology and Plastic Surgery Specialists Pllc

NPI #1043096365 in Southlake, Texas

Provider Information

NPI Number: 1043096365
Entity Type: Organization
Organization Name: Dermatology and Plastic Surgery Specialists Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: DERMATOLOGY AND PLASTIC SURGERY SPECIALISTS PLLC
Primary Specialty: Plastic Surgery
Enumeration Date: Sep 1, 2023
Last Updated: Sep 1, 2023

Practice Location

Address: 245 W STATE HIGHWAY 114 SUITE 100
City: Southlake
State: Texas
ZIP Code: 76092
Phone: (817) 912-1200

Authorized Official

Name: JASON KYLE POTTER, MD
Title: PHYSICIAN
Phone: (214) 930-6588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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