DERMATOLOGY & PLASTIC SURGERY ASSOCIATION INC. NPI 1023255254

NPI Information

  • NPI: 1023255254
  • Provider Name: DERMATOLOGY & PLASTIC SURGERY ASSOCIATION, INC.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 3115 PINE AVE
    SUITE 908
    WACO, TX
    ZIP 76708
  • Phone: (254) 752-2575

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NPI Details

DERMATOLOGY & PLASTIC SURGERY ASSOCIATION, INC. is a specialist in Waco, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY & PLASTIC SURGERY ASSOCIATION, INC. NPI is 1023255254. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3115 PINE AVE
SUITE 908
WACO, TX
ZIP 76708-247
Phone: (254) 752-2575
Fax: (254) 752-0188

The provider's authorized official is Robert A.m. Gardere .
The authorized official title is President and has the following contact phone number (254) 752-2575.

The enumeration date for this NPI number is 1/9/2009 and was last updated on 1/9/2009.

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
1174400000XSpecialistE7938TEXASYes

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
100CR41MEDICARE PINTEXAS
21303794-02MEDICAIDTEXAS
300CR41OTHERTEXASBLUECROSS BLUESHIELD OF TEXAS

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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