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

Clinique Dallas Plastic Surgery PLLC

Organization Plastic Surgery Physician · NPI 1689808941

Clinique Dallas Plastic Surgery PLLC is a Plastic Surgery Physician in Dallas, Texas. Licensed in Texas. Registered with an NPI since 2009.

Licensed in
TX
In the registry since
2009
Specialties on file
2
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

7777 Forest Ln Ste C212
Dallas, TX 75230-6836
Phone: (972) 566-2010
Fax: (855) 592-2934
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 (TX)
Plastic Surgery Physician Taxonomy 208200000X

Record details

NPI number1689808941
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Antonetti — Ceo/Surgeon · (972) 566-2010
NPI enumeratedMay 14, 2009
Last updated in NPPESSeptember 23, 2025
Certification dateSeptember 23, 2025
Mailing address7777 Forest Ln Ste C212, Dallas, TX 75230-6836

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