Organization
EYE PLASTIC SURGERY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LAWRENCE MAZOW (MD)
(972) 566-2020
Entity
Organization
Contact information
Practice address
7777 FOREST LANE, SUITE C-710, DALLAS, TX 75230-2571
(972) 566-2020
(972) 566-5454
Mailing address
7777 FOREST LANE, SUITE C-710, DALLAS, TX 75230-2571
(972) 566-2020
(972) 566-5454
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00802T
PTAN
TX
05
—
152936401
—
TX
Enumeration date
01/31/2007
Last updated
11/02/2022
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