Organization Active NPI

Bayshore Dermatology Clinic

  • Dermatology Physician
  • Pasadena, TX
National Provider Identifier
1063004810
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BAYSHORE DERMATOLOGY CLINIC
Practice address
3901 Woodlawn Ave
Pasadena, TX 77504-1956
Phone
(713) 946-2666
Fax
(713) 946-9595
NPI assigned
Feb 3, 2021
Last updated
Feb 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
William Tausend, MDNPI 1134549140
Title
Owner
Phone
(713) 946-2666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

3901 Woodlawn Ave
Pasadena, TX 77504-1956

Mailing address

3901 Woodlawn Ave
Pasadena, TX 77504-1956
Phone (713) 946-2666

National Provider Directory

National Provider Directory

Locations

3901 Woodlawn Ave
Pasadena, TX 77504
Phone (713) 946-2666

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1063004810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 WOODLAWN AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041956",
            "telephone_number": "713-946-2666",
            "fax_number": "713-946-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 WOODLAWN AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041956",
            "telephone_number": "713-946-2666",
            "fax_number": "713-946-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE DERMATOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "TAUSEND",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-946-2666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.