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DYNAMIC DERMATOLOGY PLLC NPI 1043876568


NPI Information

NPI: 1043876568
Provider Name: DYNAMIC DERMATOLOGY, PLLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 45D2190404

Address:
13535 HAUSMAN PASS STE 104
SAN ANTONIO, TX
ZIP 78249
Phone: (210) 951-5530
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DYNAMIC DERMATOLOGY, PLLC is a medical specialty clinic center in San Antonio, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). DYNAMIC DERMATOLOGY, PLLC NPI is 1043876568. The provider is registered as an organization entity type.

The provider's business location address is:

13535 HAUSMAN PASS STE 104
SAN ANTONIO, TX
ZIP 78249-581
Phone: (210) 951-5530
Fax: (210) 951-9080

The provider's authorized official is Sarah Groff .
The authorized official title is President and has the following contact phone number (210) 951-5530.

The CLIA number assigned to this NPI record is 45D2190404 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2019 and was last updated on 8/6/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyYes

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: 4/28/2024

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