OrganizationActive
Breast Recon Specialists, PLLC
NPI 1104348614 · Plastic and Reconstructive Surgery Physician · Colleyville, TX
Provider details
- NPI number
- 1104348614
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jon Ver Halen, MD(817) 416-8080
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7167 Colleyville Blvd Ste 102
Colleyville, TX 76034-8002
Phone: (817) 484-0169
Approximate (ZIP-level) locationGet directions
Mailing address
1717 Wisteria Way
Westlake, TX 76262-9083
Registry dates
- Enumerated
- 2017-07-17
- Last updated
- 2020-08-05
- Certified
- 2020-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.