VITALOGY P.A. NPI 1023215662

NPI Information

  • NPI: 1023215662
  • Provider Name: VITALOGY P.A.
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • Doing Business As: VITALOGY SKINCARE
  • CLIA Number: 45D1069391
  • Address: 4513 WILLIAMS DR
    GEORGETOWN, TX
    ZIP 78633
  • Phone: (512) 930-3909

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NPI Details

VITALOGY P.A. is a dermatology in Georgetown, TX. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. VITALOGY P.A. NPI is 1023215662. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Vitalogy Skincare.

The provider's business location address is:

4513 WILLIAMS DR
GEORGETOWN, TX
ZIP 78633-302
Phone: (512) 930-3909
Fax: (512) 240-5469

The provider's authorized official is John Ramm .
The authorized official title is Cfo and has the following contact phone number (512) 930-3909.

The CLIA number assigned to this NPI record is 45D1069391 - practitioner other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/28/2007 and was last updated on 2/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyM5607TEXASYes
2207ND0101XDermatologyMOHS-Micrographic SurgeryM5607TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100Y576MEDICARE PINTEXAS
2301405MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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