Brenham Dermatology PLLC

Organization Active NPI Dermatology Physician · Brenham, TX

NPI 1104149012 · NPPES record last updated Aug 25, 2011

Key facts

NPI
1104149012
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
License
L2758 (TX)
Legal business name
BRENHAM DERMATOLOGY PLLC
Practice address
1910 Niebuhr
Brenham, TX 77833-5037
Phone
(979) 353-4267
NPI assigned
Mar 5, 2010
Organization subpart
No

Authorized official

Name
Dr. Christy A Woodruff, MD
Title
Owner
Phone
(979) 353-4267

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2097493Brenham Dermatology
1910 Niebuhr Street, Brenham, TX 77833
ComplianceMar 6, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207N00000X L2758 TX Yes

Addresses

Primary practice location

1910 Niebuhr
Brenham, TX 77833-5037

Mailing address

1910 Niebuhr St
Brenham, TX 77833-5037
Phone (979) 353-4267

Other providers in Brenham, TX

All providers in Brenham, TX · Dermatology Physician in Texas

Sources for this page

Verify at the official NPI Registry.