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SOUTHLAKE PLASTIC SURGERY
NPI 1255519344
Plastic Surgery in Southlake, TX

Active since January 31, 2008CLIA 45D2248488 · Waiver
900 E SOUTHLAKE BLVD, STE 100, SOUTHLAKE, TX 76092(817) 442-8900(817) 488-2490 Get Directions Write a Review

NPPES record last updated: January 31, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southlake Plastic Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHLAKE PLASTIC SURGERY (NPI 1255519344) is a healthcare organization registered as a plastic surgery in Southlake, Texas and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through January 12, 2028 and lists Mark E Mason, Owner, as its authorized official.

NPPES Registry Identity

NPI1255519344
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameSOUTHLAKE PLASTIC SURGERY
Location Address900 E SOUTHLAKE BLVD, STE 100Southlake, TX 76092-6375
Mailing Address900 E Southlake Blvd, Ste 100Southlake, TX 76092-6375 · (817) 442-8900 · Fax (817) 488-2490
Phone(817) 442-8900
Fax(817) 488-2490
Organization SubpartNo
Authorized OfficialMark E MasonOwner · (817) 442-8900
Enumeration DateJanuary 31, 2008
✔ NPI 1255519344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License J4330 (TX)
900 E SOUTHLAKE BLVD, Southlake, TX 76092
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Other Identifiers 2

Other0037EMTX · Bcbstx Grp Number
Medicare PIN00817N

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2248488

Southlake Plastic Surgery, PA · Southlake, TX
Active · expires Jan 12, 2028
CLIA Number45D2248488
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2026
Certificate Expiration DateJanuary 12, 2028
Laboratory DirectorMark E. Mason
Laboratory Phone(817) 442-8900
Laboratory LocationSouthlake Plastic Surgery, PA900 E Southlake Blvd Suite 100, Southlake, TX 76092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLIN ELIZABETH PEDIGO RNFA
Registered Nurse (Registered Nurse First Assistant)
900 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 442-8900
DR. MADIHA ELHAM HUQ DO
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
MARK E MASON MD
Oral & Maxillofacial Surgery
900 E SOUTHLAKE BLVD, STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 442-8900
DR. ROBIN ANNETTE HALL D.O.
Family Medicine (Adult Medicine)
900 E SOUTHLAKE BLVD, SUITE 200
SOUTHLAKE, TX 76092
Tarrant County (817) 310-6050
DESTINATION HEALTH
Family Medicine (Adult Medicine)
900 E SOUTHLAKE BLVD, SUITE 200
SOUTHLAKE, TX 76092
Tarrant County (817) 310-6050
ALIREZA ALLEN SHAKOURI MD
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
TEXAS REGIONAL ASTHMA & ALLERGY CENTER
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770
DR. RENE ALBERT LEON M.D.
Allergy & Immunology (Allergy)
900 E SOUTHLAKE BLVD, STE 300
SOUTHLAKE, TX 76092
Tarrant County (817) 421-0770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southlake Plastic Surgery's NPI number?

The NPI number for Southlake Plastic Surgery is 1255519344. It was assigned to this organization in the NPPES registry on January 31, 2008.

Where is Southlake Plastic Surgery located?

Southlake Plastic Surgery is located at 900 E Southlake Blvd Ste 100, Southlake, TX 76092. The listed phone number is (817) 442-8900.

What is Southlake Plastic Surgery's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Does Southlake Plastic Surgery hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2248488) is associated with this NPI, valid through January 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southlake Plastic Surgery was last updated on January 31, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.