Provider Demographics
NPI:1396578654
Name:ARBORSHADE DERMATOLOGY, PLLC
Entity type:Organization
Organization Name:ARBORSHADE DERMATOLOGY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEMENSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-833-5300
Mailing Address - Street 1:702 W ARAPAHO RD STE 104
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4154
Mailing Address - Country:US
Mailing Address - Phone:214-833-5300
Mailing Address - Fax:972-634-6349
Practice Address - Street 1:702 W ARAPAHO RD STE 104
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4154
Practice Address - Country:US
Practice Address - Phone:214-833-5300
Practice Address - Fax:972-634-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty