Provider Demographics
NPI:1093122723
Name:OASIS DERMATOLOGY STARR COUNTY PLLC
Entity Type:Organization
Organization Name:OASIS DERMATOLOGY STARR COUNTY PLLC
Other - Org Name:DERMATOLOGY CLINIC OF STARR COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:469-658-9004
Mailing Address - Street 1:3100 BUDDY OWENS AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6464
Mailing Address - Country:US
Mailing Address - Phone:956-971-0404
Mailing Address - Fax:
Practice Address - Street 1:2764 PHARMACY RD
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6201
Practice Address - Country:US
Practice Address - Phone:956-971-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4533207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty