Provider Demographics
NPI:1346948130
Name:PURE DERMATOLOGY PLLC
Entity Type:Organization
Organization Name:PURE DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-766-2610
Mailing Address - Street 1:8701 W HIGHWAY 71 STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8380
Mailing Address - Country:US
Mailing Address - Phone:512-923-8826
Mailing Address - Fax:510-766-2620
Practice Address - Street 1:8701 W HIGHWAY 71 STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8380
Practice Address - Country:US
Practice Address - Phone:512-766-2610
Practice Address - Fax:512-766-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty