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Organization

MP PLASTIC SURGERY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MAXIM PEKAREV M.D. (PHYSICIAN/OWNER)
(817) 529-9199
Entity
Organization

Contact information

Practice address
800 8TH AVE STE 206, FORT WORTH, TX 76104-2619
(817) 529-9199
(817) 334-0491
Mailing address
800 8TH AVE STE 206, FORT WORTH, TX 76104-2619
(817) 529-9199
(817) 334-0491

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
P5223
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
328016601
TX
Enumeration date
01/21/2015
Last updated
10/11/2023
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