SKIN SURGERY CENTER, PA (NPI# 1811229180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811229180 |
| Entity Type | Organization |
| Organization Name | SKIN SURGERY CENTER, PA |
| Practice Address |
6208 Colleyville Blvd Suite 100 Colleyville TX 76034-6223 |
| Mailing Address |
3000 S Hulen St Suite 124-228 Fort Worth TX 76109-1929 |
| Practice Telephone | 8179245200 |
| Practice Fax Number | 8179245266 |
| Mailing Telephone | 8179245200 |
| Mailing Fax Number | 8179245266 |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |
| Authorized Official Name | DR. DIEGO E. MARRA (DIRECTOR) |
| Authorized Official Telephone | 8179245200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
M5353 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
6208 COLLEYVILLE BLVD SUITE 100 |
| City | COLLEYVILLE |
| State | TX |
| Zip Code | 76034-6223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967283 | Lumi Eye Care | Optometrist | 3855 Glade Road, Colleyville, TX 76034 | 2020-09-17 |
| 1528552718 | Dental Sc, Pllc | Dentist | 6700 Colleyville Blvd, Colleyville, TX 76034 | 2018-06-20 |
| 1447763503 | Pekam Takusi | Pharmacist | 704 Strauss, Colleyville, TX 76034 | 2017-11-13 |
| 1982128484 | Van Beljon LLC | Chiropractor | 1124 Glade Rd, Suite 140, Colleyville, TX 76034 | 2017-07-27 |
| 1871031120 | Gena Willams | Occupational Therapist | 4113 Gateway Dr #200, Colleyville, TX 76034 | 2017-02-07 |
| 1700255486 | Village Lane Apothecary | Pharmacy | 60 Village Ln, Suite 130, Colleyville, TX 76034 | 2015-09-23 |
| 1679968333 | Amber Robinson | Counselor | 5209 Heritage Ave #210, Colleyville, TX 76034 | 2015-03-31 |
| 1013305978 | Stat Sleep of Colleyville, LLP | Clinic/Center | 6407 Colleyville Blvd Ste B, Colleyville, TX 76034 | 2014-12-30 |
| 1528468717 | Colverse Iom LLC | Neurological Surgery | 1308 Somerset Ct, Colleyville, TX 76034 | 2014-08-26 |
| 1356752703 | Ideal Dental of Colleyville, Pllc | Dentist | 4712 Colleyville Blvd, Suite 110, Colleyville, TX 76034 | 2014-05-19 |
| Find all providers in zip 76034 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| 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. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649800848 | Skin Cancer Dermatology, Pllc | Dermatology | 3327 Research Plz Ste 414, San Antonio, TX 78235-5159 | 2020-01-16 |
| 1598302721 | Austin Skin Pllc | Dermatology | 1501 Dorothy Nichols Ln # B, Smithville, TX 78957-1725 | 2019-12-06 |
| 1154717726 | Joshua Lee Owen | Dermatology | 2632 Broadway, Suite 300 South, San Antonio, TX 78215-7821 | 2015-04-10 |
| 1043615263 | Epiphany Dermatology Pa | Dermatology | 7106 Sanger Avenue, Waco, TX 76712-3928 | 2014-10-30 |
| 1255745915 | Leon Chen | Dermatology | 6655 Travis St Ste 650, Houston, TX 77030-1316 | 2014-06-19 |
| 1750624391 | Houston Skin Cancer Associates, Pllc | Dermatology | 1401 Binz Street, Suite 200, Houston, TX 77004 | 2013-04-02 |
| 1457695413 | Oliver Street 5.01(a) Inc. | Dermatology | 5310 Harvest Hill Rd Ste 290, Dallas, TX 75230-5826 | 2012-11-15 |
| 1427330588 | Michael A. Sorace Md Pa | Dermatology | 7950 Floyd Curl Dr Ste 505, Medical Center Tower 1, San Antonio, TX 78229-3924 | 2011-09-15 |
| 1265614168 | Michael Sorace | Dermatology | 745 W San Antonio Ave, Suite 100, Boerne, TX 78006-3213 | 2007-12-03 |
| 1780872762 | Susan E Dozier, Md, Pa | Dermatology | 8240 N Mopac Expy Ste 355, Austin, TX 78759-8894 | 2007-10-04 |
| Find all providers with the same taxonomy | ||||
| City | COLLEYVILLE |
| Zip Code | 76034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.