Organization
BURN AND RECONSTRUCTIVE CENTERS OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN FAGAN (OWNER/MD)
(706) 863-9595
Entity
Organization
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(706) 863-9595
(706) 868-8375
Mailing address
PO BOX 12187, AUGUSTA, GA 30914-2187
(706) 863-9595
(706) 868-8375
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
05/14/2015
Last updated
12/02/2024
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