Organization
ADVANCED RECONSTRUCTIVE PLASTIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI REZA ABTAHI DO (MANAGING MEMBER)
(469) 293-2533
Entity
Organization
Contact information
Practice address
1900 E STATE HIGHWAY 114 STE 140, SOUTHLAKE, TX 76092-6510
(469) 293-2533
Mailing address
1900 E STATE HIGHWAY 114 STE 140, SOUTHLAKE, TX 76092-6510
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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