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

Breast Recon Specialists, PLLC

Organization Plastic and Reconstructive Surgery Physician · NPI 1104348614

Breast Recon Specialists, PLLC is a Plastic and Reconstructive Surgery Physician in Colleyville, Texas. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

7167 Colleyville Blvd Ste 102
Colleyville, TX 76034-8002
Phone: (817) 484-0169
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X

Record details

NPI number1104348614
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jon Ver Halen — Md · (817) 416-8080
NPI enumeratedJuly 17, 2017
Last updated in NPPESAugust 5, 2020
Certification dateAugust 5, 2020
Mailing address1717 Wisteria Way, Westlake, TX 76262-9083