# LAKE JACKSON PLASTIC SURGERY, PA

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

## Provider details

- **NPI number:** 1912259698
- **Authorized official:** DR. ROBERT SCOTT YARISH M.D. (PRESIDENT)
- **Authorized official phone:** (713) 467-0146

## Contact information

- **Practice address:** 215 OAK DR S, SUITE J, LAKE JACKSON, TX 77566-5629
- **Practice address phone:** (979) 480-0105
- **Practice address fax:** (979) 480-0106
- **Mailing address:** 10565 KATY FWY, SUITE 100, HOUSTON, TX 77024-1007
- **Mailing address phone:** (713) 467-0146
- **Mailing address fax:** (713) 467-9413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | H2191 | TX | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 10/05/2012