Organization
DERMATOLOGY AND PLASTIC SURGERY SPECIALISTS PLLC
Active
Parent organization
DERMATOLOGY AND PLASTIC SURGERY SPECIALISTS PLLC
Other names
Plastic Surgery Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERMATOLOGY AND PLASTIC SURGERY SPECIALISTS PLLC
Authorized official
JASON KYLE POTTER MD (PHYSICIAN)
(214) 930-6588
Entity
Organization
Contact information
Practice address
245 W STATE HIGHWAY 114 SUITE 100, SOUTHLAKE, TX 76092
(817) 912-1200
Mailing address
245 W STATE HIGHWAY 114 SUITE 100, SOUTHLAKE, TX 76092
(817) 912-1200
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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