# ADVANCED COSMETIC SURGERY CTR WM K MILES MD PA

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

## Provider details

- **NPI number:** 1811164296
- **Authorized official:** DR. WILLIAM KEITH MILES MD (PRESIDENT)
- **Authorized official phone:** (817) 336-9131

## Contact information

- **Practice address:** 800 8TH AVENUE, SUITE 404, FORT WORTH, TX 76104-2618
- **Practice address phone:** (817) 336-9131
- **Practice address fax:** (817) 336-9457
- **Mailing address:** 800 8TH AVENUE, SUITE 404, FORT WORTH, TX 76104-2618
- **Mailing address phone:** (817) 336-9131
- **Mailing address fax:** (817) 336-9457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | D2529 | TX | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/14/2008