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NORTHSTAR DERMATOLOGY PA NPI 1407176043


NPI Information

NPI: 1407176043
Provider Name: NORTHSTAR DERMATOLOGY, PA
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 45D2016074

Address:
5320 N TARRANT PKWY
SUITE 200
FORT WORTH, TX
ZIP 76244
Phone: (817) 427-3376
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NORTHSTAR DERMATOLOGY, PA is a dermatology in Fort Worth, 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. NORTHSTAR DERMATOLOGY, PA NPI is 1407176043. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5320 N TARRANT PKWY
SUITE 200
FORT WORTH, TX
ZIP 76244-387
Phone: (817) 427-3376
Fax: (817) 427-3379

The provider's authorized official is Sina Aboutalebi .
The authorized official title is Owner and has the following contact phone number (817) 427-3376.

The CLIA number assigned to this NPI record is 45D2016074 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/6/2010 and was last updated on 2/17/2011.


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
1207N00000XDermatologyTEXASYes

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: 11/14/2023

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