Provider Demographics
NPI:1003853433
Name:DERMATOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:DERMATOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPEACILIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-243-4530
Mailing Address - Street 1:10 MEDICAL PKWY
Mailing Address - Street 2:PLAZA 3 SUITE #304
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-243-4530
Mailing Address - Fax:972-406-1950
Practice Address - Street 1:10 MEDICAL PKWY
Practice Address - Street 2:PLAZA 3 SUITE #304
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7840
Practice Address - Country:US
Practice Address - Phone:972-243-4530
Practice Address - Fax:972-406-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH2364Medicare UPIN
TXE4506Medicare UPIN