Provider Demographics
NPI:1841012168
Name:DERMATOLOGY SPECIALISTS OF AMERICA PLLC
Entity type:Organization
Organization Name:DERMATOLOGY SPECIALISTS OF AMERICA PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:559-359-8237
Mailing Address - Street 1:240 YOSEMITE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078
Mailing Address - Country:US
Mailing Address - Phone:559-359-8237
Mailing Address - Fax:
Practice Address - Street 1:5236 W. UNIVERSITY DR.
Practice Address - Street 2:SUITE 2200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:866-406-3376
Practice Address - Fax:469-406-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty