Organization
ELITE PLASTIC & RECONSTRUCTIVE SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEOWALL CHATTAR-CORA MD (OWNER/MD)
(210) 265-1924
Entity
Organization
Contact information
Practice address
11212 STATE HIGHWAY 151, MEDICAL PLAZA #2 SUITE 230, SAN ANTONIO, TX 78251-4498
(210) 265-1924
(210) 265-3387
Mailing address
1931 ROGERS RD STE 104, SAN ANTONIO, TX 78251-4853
(210) 265-1924
(210) 265-3387
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
M3496
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313312
PTAN
TX
Enumeration date
03/25/2013
Last updated
12/30/2024
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