Baytown Dermatology, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D3267 Issued in TX

Legal business name

BAYTOWN DERMATOLOGY, P.A.

Practice address

3730 Emmett Hutto Blvd
Baytown, TX 77521-1764

Phone

(281) 425-9375

Fax

(281) 427-4584

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Conner Chan, MDNPI 1962669515

Title

Ceo

Phone

(281) 425-9375

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Conner Chan, MD

  • Dermatology Physician
  • Baytown, TX
  • NPI 1962669515
  Medicare reassignment Care Compare group NPD Authorized official
• Ramon Larrea Sanchez, M.D.

  • Dermatology Physician
  • Galveston, TX
  • NPI 1366556193
  Medicare reassignment Care Compare group NPD
• Ashley Rae Group, MD

  • Dermatology Physician
  • Keene, NH
  • NPI 1558528406
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1033325550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYTOWN DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CONNER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-425-9375",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "D3267",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "45D0496518",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0038BH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG4065",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baymont Eyecare PLLC
• Baytown ASC, LP
• Baytown Cardiology and Associates
• Baytown Dental Care, PLLC
• Baytown Dental Group
• Baytown Dermatology, P.a.
• Baytown Emergency Center, LLC
• Baytown Emergency Physician Group, PLLC
• Baytown Endoscopy Center, LLC
• Baytown Eye Care

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.