Organization
LARSON'S COSMETIC BREAST SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CROSS (CLINICAL DIRECTOR)
(409) 833-0193
Entity
Organization
Contact information
Practice address
950 N 11TH ST, BEAUMONT, TX 77702-1203
(409) 833-0193
Mailing address
950 N 11TH ST, BEAUMONT, TX 77702-1203
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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