Provider Demographics
NPI:1164904082
Name:GREER DERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:GREER DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:HELDT
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-631-0310
Mailing Address - Street 1:1200 N CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-4512
Mailing Address - Country:US
Mailing Address - Phone:817-631-0310
Mailing Address - Fax:817-631-0340
Practice Address - Street 1:1200 N CARROLL AVE
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4512
Practice Address - Country:US
Practice Address - Phone:817-631-0310
Practice Address - Fax:817-631-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5723207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty