CENTRAL TEXAS DERMATOLOGY PA NPI 1164566246

NPI Information

  • NPI: 1164566246
  • Provider Name: CENTRAL TEXAS DERMATOLOGY, PA
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 102 WESTLAKE DR
    #100
    WEST LAKE HILLS, TX
    ZIP 78746
  • Phone: (512) 327-7779

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NPI Details

CENTRAL TEXAS DERMATOLOGY, PA is a specialist in West Lake Hills, 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. CENTRAL TEXAS DERMATOLOGY, PA NPI is 1164566246. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

102 WESTLAKE DR
#100
WEST LAKE HILLS, TX
ZIP 78746
Phone: (512) 327-7779

The provider's authorized official is Debra Petrie .
The authorized official title is Biller/credentialer and has the following contact phone number (512) 327-8449.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 9/13/2023.

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
1174400000XSpecialistF4405TEXASYes

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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