Fustok Cosmetic and Reconstructive Surgery PA
NPI 1720569817ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Houston, TX
Surgery, Plastic and Reconstructive Surgery in Houston, Texas, registered in NPPES in August 2018. The authorized official on file is Jenni Diaz, Medical Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1720569817 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 27, 2018 |
| Last updated in NPPES | Dec 6, 2024 |
| Certified by provider | Dec 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | F4727 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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