NPI 1063003754 · live from the CMS NPI Registry
Basin Dermatology
Dermatology in Midland, TX. National Provider Identifier 1063003754, active.
NPI record
| NPI | 1063003754 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 4214 Andrews Hwy Ste 110, Midland, TX 79703 |
| Practice phone | 432-689-2491 |
| Mailing address | 4214 Andrews Hwy Ste 240, Midland, TX 79703 |
| Enumerated | January 27, 2021 |
| Last updated | January 27, 2021 |
| Authorized official | Candace Wynne, Credentialing Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.