Provider Demographics
NPI:1518266709
Name:DERMATOLOGY PHYSICIANS OF DENTON, P.A.
Entity Type:Organization
Organization Name:DERMATOLOGY PHYSICIANS OF DENTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-4034
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C-755
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2584
Mailing Address - Country:US
Mailing Address - Phone:972-566-4034
Mailing Address - Fax:972-566-2121
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C-755
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2584
Practice Address - Country:US
Practice Address - Phone:972-566-4034
Practice Address - Fax:972-566-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty