Warthan Dermatology Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D8472 Issued in TX

Legal business name

WARTHAN DERMATOLOGY CENTER

Practice address

4730 NE Stallings Dr
Nacogdoches, TX 75965-1615

Phone

(936) 564-6107

Fax

(936) 564-5124

NPI assigned

Dec 14, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jaclyn R Hill

Title

Billing

Phone

(817) 923-8220

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• T Lynn Warthan, MD

  • Dermatology Physician
  • Nacogdoches, TX
  • NPI 1679647317
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1003350760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651615",
            "telephone_number": "936-564-6107",
            "fax_number": "936-564-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651615",
            "telephone_number": "936-564-6107",
            "fax_number": "936-564-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARTHAN DERMATOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "817-923-8220"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "D8472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #09400)
• Latoya Walker, MA
• Dayna Wall
• Gregory Scott Wallis, CRNA
• Aisha Ligon Warfield, APRN
• Warthan Dermatology Nacogdoches PLLC
• T Lynn Warthan, MD
• Melinda Watts, ATC
• Daniel Allison Weaver, D.D.S.,M.S
• Deana Marie Weaver

• Dermatology Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.