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Organization
YOUTHFUL ESSENCE MEDICAL SKIN AND LASER PC
Active
Organization
YOUTHFUL ESSENCE MEDICAL SKIN AND LASER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S GOMEZ (MEDICAL DIRECTOR)
(281) 693-7546
Entity
Organization
Contact information
Practice address
414 WEST GRAND PARKWAY, 115, KATY, TX 77494
(281) 693-7546
(281) 693-7548
Mailing address
414 WEST GRAND PARKWAY, 115, KATY, TX 77494
(281) 693-7546
(281) 693-7548
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J4824
TX
207Q00000X
Family Medicine Physician
J4824
TX
2086S0129X
Vascular Surgery Physician
J4824
TX
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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