Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dermatology and Plastic Surgery Specialists PLLC

Organization Plastic Surgery Physician · NPI 1043096365

Dermatology and Plastic Surgery Specialists PLLC provides Plastic Surgery Physician services in Southlake, Texas. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

245 W State Highway 114 Ste 100
Southlake, TX 76092
Phone: (817) 912-1200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1043096365
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDermatology and Plastic Surgery Specialists PLLC
Authorized official Jason Potter — Physician · (214) 930-6588
Other names Plastic Surgery Specialists
NPI enumeratedSeptember 1, 2023
Last updated in NPPESSeptember 1, 2023
Certification dateSeptember 1, 2023
Mailing address245 W State Highway 114 Suite 100, Southlake, TX 76092

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