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

Polavarapu Plastic Surgery, PLLC

Organization Plastic Surgery Physician · NPI 1982148326

Polavarapu Plastic Surgery, PLLC is a Plastic Surgery Physician in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
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

4455 Camp Bowie Blvd Ste 114-30
Fort Worth, TX 76107-3864
Phone: (773) 710-6128
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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 · Licence Q0809 (TX)

Record details

NPI number1982148326
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kiran Polavarapu — Owner · (817) 615-8576
NPI enumeratedDecember 5, 2016
Last updated in NPPESJanuary 31, 2017
Mailing address4455 Camp Bowie Blvd, Suite 114-30, Fort Worth, TX 76107-3864

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