Provider Demographics
NPI:1659646180
Name:BYRKERWOOD SKIN AND VEIN CENTER, P.A.
Entity Type:Organization
Organization Name:BYRKERWOOD SKIN AND VEIN CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JACULEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-302-4047
Mailing Address - Street 1:1600 W 38TH ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6400
Mailing Address - Country:US
Mailing Address - Phone:512-302-1529
Mailing Address - Fax:
Practice Address - Street 1:1600 W 38TH ST
Practice Address - Street 2:SUITE 315
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6400
Practice Address - Country:US
Practice Address - Phone:512-302-1529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID