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ADVANCED DERMATOLOGY AND SKIN CARE PA NPI 1710917521


NPI Information

NPI: 1710917521
Provider Name: ADVANCED DERMATOLOGY AND SKIN CARE PA
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 45D1081654

Address:
430 S MASON RD
SUITE 101
KATY, TX
ZIP 77450
Phone: (281) 392-3803
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ADVANCED DERMATOLOGY AND SKIN CARE PA is a dermatology in Katy, 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. ADVANCED DERMATOLOGY AND SKIN CARE PA NPI is 1710917521. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

430 S MASON RD
SUITE 101
KATY, TX
ZIP 77450-447
Phone: (281) 392-3803
Fax: (281) 392-6766

The provider's authorized official is Kelly Duncan .
The authorized official title is Practice Owner and has the following contact phone number (281) 392-3803.

The CLIA number assigned to this NPI record is 45D1081654 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 4/19/2016.


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
1207N00000XDermatologyYes

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
1DD9883OTHERRR MEDICARE GRP BRAZORIA
245D1019065OTHERCLIA NUMBER
300482VMEDICARE PINTEXAS
400X105MEDICARE PINTEXAS
50042KKOTHERBCBS
600283ZMEDICARE PINTEXAS
7DA6818OTHERRR MEDICARE GRP HARRIS CO
845D2052501OTHERTEXASCLIA

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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