Organization
WESTSIDE PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOLORES WALLACE (OFFICE MANAGER)
(817) 961-1950
Entity
Organization
Contact information
Practice address
3416 LOVELL AVE STE 110, FORT WORTH, TX 76107-5718
(817) 961-1950
(817) 887-3105
Mailing address
3416 LOVELL AVE STE 110, FORT WORTH, TX 76107-5718
(817) 961-1950
(817) 887-3105
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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