FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA – Plastic and Reconstructive Surgery Physician, NPI 1720569817

FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA is a healthcare provider. based in Bellaire, Texas. specializing in Plastic and Reconstructive Surgery Physician. The organization holds a License No. F4727 (TX). The NPI Number for FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA is 1720569817

Main info

Organization
Name
FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA
NPI
1720569817
Phone
(713) 621-2950
Address
6750 WEST LOOP S STE 830
Authorized Official
MS. JENNI DIAZ MEDICAL BILLING MANAGER
Enumeration Date
27 August 2018
Last Update Date
6 December 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

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Provider Addresses for FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA

  • West Loop South, Bellaire, Harris County, Texas, 77027, United States

    BELLAIRE, TX 774014117

    Phone: (713) 621-2950

    Fax: (713) 621-2139

    Type: Mailing

  • 333 WEST LOOP N STE 410

    HOUSTON, TX 770247709

    Phone: (713) 621-2950

    Fax: (713) 589-2011

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-11-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-11-30 (922 days ago).

Enrollment records

1

Earliest due date

2023-11-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20181106002121OClinic/Group PracticeTX2023-11-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77401)

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Reviews

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Frequently asked questions

What identifier follows FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA across health systems?
The NPI 1720569817 uniquely identifies FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA in U.S. healthcare data.
Quick check: is FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA active?
Public NPPES data shows FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA with an active NPI status right now.
What type of care does FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA provide?
FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA's profile centers on Plastic and Reconstructive Surgery Physician. Clinical services aligned with this taxonomy classification.
Is FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA tied to Bellaire, Texas?
If you are local to Bellaire, Texas, FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA may be relevant to your search.
Who maintains FUSTOK COSMETIC AND RECONSTRUCTIVE SURGERY PA's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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