NPI 1710028295 · live from the CMS NPI Registry
Advanced Dermatologic Surgery PA
Dermatology, MOHS-Micrographic Surgery in Houston, TX. National Provider Identifier 1710028295, active.
NPI record
| NPI | 1710028295 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, MOHS-Micrographic Surgery 207ND0101X |
| Practice location | 1213 Hermann Dr, Suite #650, Houston, TX 77004 |
| Practice phone | 713-528-8882 |
| Mailing address | 5310 Harvest Hill Rd Suite 290, Dallas, TX 75320 |
| Enumerated | February 9, 2007 |
| Last updated | November 13, 2019 |
| Authorized official | Lawrence Anderson, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — |
| Dermatology, MOHS-Micrographic Surgery primary | 207ND0101X | M6002 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.