| NPI | 1437617255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A. NIKOLAIDIS Owner 512-328-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |