Organization
COSMETIC IMAGE LASER SOLUTION, LLC
Active
Organization
COSMETIC IMAGE LASER SOLUTION, LLC
Active
Other names
Creative Image Laser Solution
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY N BUTKA M.D. (OWNER)
(325) 642-4014
Entity
Organization
Contact information
Practice address
3661 HWY 377 SOUTH, BROWNWOOD, TX 76801-5900
(325) 642-4014
Mailing address
3661 HWY 377 SOUTH, BROWNWOOD, TX 76801-5900
(325) 642-4014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G6479
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G6479
TX MEDICAL LICENSE
TX
Enumeration date
12/03/2007
Last updated
11/18/2008
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