SUMMIT DERMATOLOGY, PLLC (NPI# 1912418963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912418963 |
| Entity Type | Organization |
| Organization Name | SUMMIT DERMATOLOGY, PLLC |
| Practice Address |
1038 S Fleishel Ave Tyler TX 75701-2044 |
| Practice Telephone | 9035939474 |
| Practice Fax Number | 9035939477 |
| Mailing Telephone | 9035939474 |
| Mailing Fax Number | 9035939477 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |
| Authorized Official Name | JASON L BLASER (PRESIDENT) |
| Authorized Official Telephone | 9035939474 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
K9734 | TX | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | K9734 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1038 S FLEISHEL AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265477681 | Jason L. Blaser | Dermatology | 1038 S Fleishel Ave, Tyler, TX 75701-2044 | 2006-06-19 |
| 1518420314 | Nicolas Alfonso Elizondo | Physician Assistant | 1038 S Fleishel Ave, Tyler, TX 75701-2044 | 2019-04-09 |
| 1689010340 | Charity Joy Burkhardt | Physician Assistant | 1038 S Fleishel Ave, Tyler, TX 75701-2044 | 2013-05-21 |
| 1407875248 | Thomas W. Lyles | Specialist | 1038 S Fleishel Ave, Tyler, TX 75701-2044 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679905673 | Dermatology of East Texas Pa | Dermatology | 1777 Troup Hwy., Tyler, TX 75701-0000 | 2013-08-01 |
| 1326072653 | Lisa Renee Lowry | Dermatology | 909 Ese Loop323 Ste 110, Tyler, TX 75701-9675 | 2006-07-11 |
| 1851770218 | Lambert Dermatology Clinic P.a. | Dermatology | 5791 Copeland Rd, Tyler, TX 75703-3905 | 2015-05-19 |
| 1255624474 | Lindsey Anne Hunter-ellul | Dermatology | 1367 Dominion Plz, Tyler, TX 75703-1013 | 2011-05-20 |
| 1053604389 | Bobbak Mansouri | Dermatology | 1367 Dominion Plz, Tyler, TX 75703-1013 | 2011-05-19 |
| 1225264443 | Leslie Kay Scroggins Markle | Dermatology | 1367 Dominion Plz, Tyler, TX 75703-1013 | 2009-06-02 |
| 1083818884 | Alma Criseida Berlingeri Ramos | Dermatology | 1367 Dominion Plz, Tyler, TX 75703 | 2007-06-14 |
| 1225252489 | Thomas Lambert Jr. | Dermatology | 5791 Copeland Rd, Tyler, TX 75703-3905 | 2007-04-12 |
| 1306996095 | Billy Gene Dodge | Dermatology | 1020 E Lake St, Tyler, TX 75701-2033 | 2007-01-12 |
| 1447354626 | Jennifer Dykes Holman | Dermatology | 1367 Dominion Plz, Tyler, TX 75703-1013 | 2006-09-11 |
| Find all providers in TYLER | ||||
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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.