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Organization
GULF COAST PLASTIC SURGERY P A
Active
Organization
GULF COAST PLASTIC SURGERY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY PAUL PISARSKI MD (OWNER)
(979) 297-9289
Entity
Organization
Contact information
Practice address
215 OAK DR SOUTH, STE J, LAKE JACKSON, TX 77566
(979) 297-9289
(979) 299-1007
Mailing address
215 OAK DR SOUTH, STE J, LAKE JACKSON, TX 77566
(979) 297-9289
(979) 299-1007
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00353N
MEDICARE GROUP NUMBER
TX
Enumeration date
03/01/2007
Last updated
11/03/2011
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