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

Cosmetic Surgery of Dfw PLLC

Organization Plastic Surgery Physician · NPI 1497337471

Cosmetic Surgery of Dfw PLLC is a Plastic Surgery Physician in Fort Worth, Texas. Registered with an NPI since 2021.

In the registry since
2021
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

800 12th Ave Ste 100
Fort Worth, TX 76104-2519
Phone: (817) 529-4314
Fax: (844) 210-1095
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1497337471
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dustin Derrick — Owner · (817) 529-4314
NPI enumeratedApril 28, 2021
Last updated in NPPESApril 28, 2021
Certification dateApril 28, 2021
Mailing address800 12th Ave Ste 100, Fort Worth, TX 76104-2519

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