Provider Demographics
NPI:1841616141
Name:CHERNOSKY DERMATOLOGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CHERNOSKY DERMATOLOGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-9270
Mailing Address - Street 1:4646 WILD INDIGO ST
Mailing Address - Street 2:STE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7188
Mailing Address - Country:US
Mailing Address - Phone:713-790-9270
Mailing Address - Fax:713-790-1260
Practice Address - Street 1:4646 WILD INDIGO ST
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7718
Practice Address - Country:US
Practice Address - Phone:713-790-9270
Practice Address - Fax:713-790-9270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEBRA L. CHERNOSKY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0248174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty