Provider Demographics
NPI:1740636349
Name:PRECISION DERMATOLOGY PA
Entity type:Organization
Organization Name:PRECISION DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBIASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-890-5181
Mailing Address - Street 1:PO BOX 1416
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78295-1416
Mailing Address - Country:US
Mailing Address - Phone:830-890-5181
Mailing Address - Fax:830-890-5162
Practice Address - Street 1:712 HILL COUNTRY DR STE 100
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6166
Practice Address - Country:US
Practice Address - Phone:830-890-5181
Practice Address - Fax:830-590-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty