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FORT WORTH DERMATOLOGY ASSOCIATES P A NPI 1477668747


NPI Information

NPI: 1477668747
Provider Name: FORT WORTH DERMATOLOGY ASSOCIATES P A
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
1200 W ROSEDALE ST
FORT WORTH, TX
ZIP 76104
Phone: (817) 336-8131
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FORT WORTH DERMATOLOGY ASSOCIATES P A is a mohs-micrographic surgery dermatology in Fort Worth, TX. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. FORT WORTH DERMATOLOGY ASSOCIATES P A NPI is 1477668747. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 W ROSEDALE ST
FORT WORTH, TX
ZIP 76104-454
Phone: (817) 336-8131

The provider's authorized official is James Douglas Maberry .
The authorized official title is Owner and has the following contact phone number (817) 336-8131.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 2/9/2010.


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
1207ND0101XDermatologyMOHS-Micrographic SurgeryC8359TEXASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CC8286MEDICARE PINTEXAS
200U62UMEDICARE PIN
300U62UMEDICARE UPINTEXAS
4070009295MEDICARE PINTEXAS
5070009011MEDICARE PINTEXAS
6=========OTHERTEXASTAX ID #

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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