Organization
PREMIER PLASTIC AND RECONSTRUCTIVE SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA VARNER ELLIS (PROVIDER / OWNER)
(210) 575-2876
Entity
Organization
Contact information
Practice address
7700 FLOYD CURL DR, SAN ANTONIO, TX 78229-3902
(210) 575-2876
(888) 849-4257
Mailing address
307 DEVON DR, SAN RAFAEL, CA 94903-3709
(415) 491-1210
(888) 849-4257
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0102X
Surgical Critical Care Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442357601
—
TX
Enumeration date
12/15/2021
Last updated
03/28/2026
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