Organization
WEST AVE PLASTIC SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FORREST SUSSMAN ROTH M.D. (PRESIDENT)
(713) 591-9283
Entity
Organization
Contact information
Practice address
2800 KIRBY DR, B212, HOUSTON, TX 77098-1273
(713) 591-0283
(888) 878-1489
Mailing address
2800 KIRBY DR, B212, HOUSTON, TX 77098
(713) 559-9300
(888) 878-1489
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
P1585
TX
Other
Enumeration date
12/20/2011
Last updated
05/09/2012
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