Provider Demographics
NPI:1558606533
Name:AUSTIN DERMPATH ASSOCIATES
Entity Type:Organization
Organization Name:AUSTIN DERMPATH ASSOCIATES
Other - Org Name:AUSTIN DERMPATH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ADRIEN
Authorized Official - Last Name:ADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-868-3376
Mailing Address - Street 1:3010 WILLIAMS DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2787
Mailing Address - Country:US
Mailing Address - Phone:512-868-3376
Mailing Address - Fax:512-240-5469
Practice Address - Street 1:3010 WILLIAMS DRIVE
Practice Address - Street 2:SUITE 174
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2785
Practice Address - Country:US
Practice Address - Phone:512-868-3376
Practice Address - Fax:512-240-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty