Provider Demographics
NPI:1629025739
Name:PDP OF TEXAS, PLLC
Entity Type:Organization
Organization Name:PDP OF TEXAS, PLLC
Other - Org Name:DALLAS ASSOCIATED DERMATOLOGIST, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SKLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-987-3376
Mailing Address - Street 1:12700 PARK CENTRAL DR STE 1210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1522
Mailing Address - Country:US
Mailing Address - Phone:214-987-3376
Mailing Address - Fax:469-532-0273
Practice Address - Street 1:12700 PARK CENTRAL DR STE 1210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1522
Practice Address - Country:US
Practice Address - Phone:214-987-3376
Practice Address - Fax:469-532-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty