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Organization

THE AUSTIN-WESTON CENTER FOR COSMETIC SURGERY

Active
Other names
The Austin-Weston Surgicenter
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PHYLLIS CHORAZY (CHIEF OPERATING OFFICER)
(703) 893-6168
Entity
Organization

Contact information

Practice address
1825 SAMUEL MORSE DR, RESTON, VA 20190-5317
(703) 893-6168
(703) 790-3444
Mailing address
1825 SAMUEL MORSE DR, RESTON, VA 20190-5317
(703) 893-6168
(703) 790-3444

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
178251
ANTHEM NON-PAR ID#
VA
Enumeration date
10/13/2006
Last updated
08/22/2020
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