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WESTLAKE DERMATOLOGY PA NPI 1477678993


NPI Information

NPI: 1477678993
Provider Name: WESTLAKE DERMATOLOGY PA

Doing Business As: WESTLAKE DERMATOLOGY

Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 45D2129199

Address:
1760 ROUND ROCK AVE
ROUND ROCK, TX
ZIP 78681
Phone: (512) 583-3376
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WESTLAKE DERMATOLOGY PA is a dermatology in Round Rock, TX. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. WESTLAKE DERMATOLOGY PA NPI is 1477678993. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Westlake Dermatology.

The provider's business location address is:

1760 ROUND ROCK AVE
ROUND ROCK, TX
ZIP 78681-217
Phone: (512) 583-3376
Fax: (512) 306-0222

The provider's authorized official is Gregory Nikolaidis .
The authorized official title is President and has the following contact phone number (512) 328-3376.

The CLIA number assigned to this NPI record is 45D2129199 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 11/5/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0900XDermatologyDermatopathologyTEXASNo
2207N00000XDermatologyTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100440ZMEDICARE PINTEXAS
200591TOTHERTEXASBCBS OF TEXAS GROUP#
3211724401MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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