CLINIQUE DALLAS PLASTIC SURGERY PLLC NPI 1689808941

NPI Information

  • NPI: 1689808941
  • Provider Name: CLINIQUE DALLAS PLASTIC SURGERY PLLC
  • Classification: Surgery - 2086S0122X
  • Specialization: Plastic and Reconstructive Surgery
  • Entity Type: Organization
  • Address: 7777 FOREST LN STE C212
    DALLAS, TX
    ZIP 75230
  • Phone: (972) 566-2010

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NPI Details

CLINIQUE DALLAS PLASTIC SURGERY PLLC is a plastic and reconstructive surgery surgery in Dallas, TX. The provider is a surgeon who specializes in plastic and reconstructive surgery. CLINIQUE DALLAS PLASTIC SURGERY PLLC NPI is 1689808941. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

7777 FOREST LN STE C212
DALLAS, TX
ZIP 75230-836
Phone: (972) 566-2010
Fax: (855) 592-2934

The provider's authorized official is John William Antonetti .
The authorized official title is Ceo/surgeon and has the following contact phone number (972) 566-2010.

The enumeration date for this NPI number is 5/14/2009 and was last updated on 9/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic SurgeryNo
22086S0122XSurgeryPlastic and Reconstructive SurgeryTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12931776-01MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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