Provider Demographics
NPI:1669035408
Name:TEXAS SKIN & VEIN, PLLC
Entity Type:Organization
Organization Name:TEXAS SKIN & VEIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:STRAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:210-569-1215
Mailing Address - Street 1:2241 NW MILITARY HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4927
Mailing Address - Country:US
Mailing Address - Phone:210-907-8346
Mailing Address - Fax:210-906-8907
Practice Address - Street 1:2241 NW MILITARY HWY STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4927
Practice Address - Country:US
Practice Address - Phone:210-907-8346
Practice Address - Fax:210-906-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FS8211841OtherDEA