Provider Demographics
NPI:1053505701
Name:KRIS L HOWARD MD PA
Entity Type:Organization
Organization Name:KRIS L HOWARD MD PA
Other - Org Name:WEST TEXAS DERMATOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-563-3113
Mailing Address - Street 1:8141 DORADO DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8533
Mailing Address - Country:US
Mailing Address - Phone:432-563-3113
Mailing Address - Fax:432-563-4206
Practice Address - Street 1:8141 DORADO DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8533
Practice Address - Country:US
Practice Address - Phone:432-563-3113
Practice Address - Fax:432-563-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0466207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0004QPOtherBCBS
TX00Z747Medicare PIN