Provider Demographics
NPI:1265435572
Name:BAYTOWN PLASTIC SURGERY, P.A.
Entity type:Organization
Organization Name:BAYTOWN PLASTIC SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BUFFORD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-428-7321
Mailing Address - Street 1:4301 GARTH RD
Mailing Address - Street 2:STE 101
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3157
Mailing Address - Country:US
Mailing Address - Phone:281-428-7321
Mailing Address - Fax:281-420-2396
Practice Address - Street 1:4301 GARTH RD
Practice Address - Street 2:STE 101
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3157
Practice Address - Country:US
Practice Address - Phone:281-428-7321
Practice Address - Fax:281-420-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Not Answered2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX46CVOtherBCBS GROUP
TX0008AKMedicare ID - Type Unspecified