Provider Demographics
NPI:1740628189
Name:HEIGHTS DERMATOLOGY - WILLOWBROOK, PLLC
Entity type:Organization
Organization Name:HEIGHTS DERMATOLOGY - WILLOWBROOK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-864-2659
Mailing Address - Street 1:2120 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2418
Mailing Address - Country:US
Mailing Address - Phone:713-864-2659
Mailing Address - Fax:713-864-5577
Practice Address - Street 1:8203 WILLOW PLACE DR S
Practice Address - Street 2:SUITE 165
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5655
Practice Address - Country:US
Practice Address - Phone:713-864-2659
Practice Address - Fax:713-864-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1072207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty