| Restore Aesthetics | |
|
6520 Alliance Dr Unit 110 Rockwall TX 75032-0056 | |
| (469) 242-0522 | |
| Not Available |
| Full Name | Restore Aesthetics |
|---|---|
| Speciality | Preventive Medicine |
| Location | 6520 Alliance Dr Unit 110, Rockwall, Texas |
| Authorized Official Name and Position | Lince Varughese (OWNER) |
| Authorized Official Contact | 4692420522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Aesthetics 6520 Alliance Dr Unit 110 Rockwall TX 75032-0056 Ph: (469) 242-0522 | Restore Aesthetics 6520 Alliance Dr Unit 110 Rockwall TX 75032-0056 Ph: (469) 242-0522 |
| NPI Number | 1922849728 |
|---|---|
| Provider Enumeration Date | 06/05/2024 |
| Last Update Date | 06/05/2024 |
| Certification Date | 06/05/2024 |
| Medicare PECOS PAC ID | 8729525993 |
|---|---|
| Medicare Enrollment ID | O20240806000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922849728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | () | Primary |
| Provider Name | Lince K Varughese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699193276 PECOS PAC ID: 4587915905 Enrollment ID: I20180925001523 |
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