Provider Demographics
NPI:1821567769
Name:EPIDERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:EPIDERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDRAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-888-4400
Mailing Address - Street 1:4101 GREENBRIAR DR STE 305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5244
Mailing Address - Country:US
Mailing Address - Phone:346-888-4400
Mailing Address - Fax:
Practice Address - Street 1:3609 BUSINESS CENTER DR STE 124
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4168
Practice Address - Country:US
Practice Address - Phone:346-888-4400
Practice Address - Fax:346-888-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty