# TEXAS CENTER FOR FACIAL PLASTIC & LASER SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033624663
- **Authorized official:** MS. KELLIE HAWKINS (CREDENTIALING ACCOUNT MANAGER)
- **Authorized official phone:** (210) 298-6847

## Contact information

- **Practice address:** 14603 HUEBNER RD STE 102, SAN ANTONIO, TX 78230-5469
- **Practice address phone:** (210) 468-5426
- **Practice address fax:** (210) 468-3282
- **Mailing address:** 14603 HUEBNER RD STE 102, SAN ANTONIO, TX 78230-5469
- **Mailing address phone:** (210) 468-5426
- **Mailing address fax:** (210) 468-3282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | — | TX | Yes |

## Other

- **Enumeration date:** 12/05/2017
- **Last updated:** 12/05/2017