Texas Dermatology and Skin Cancer Center, PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

N7906 Issued in TX

Legal business name

TEXAS DERMATOLOGY AND SKIN CANCER CENTER, PLLC

Practice address

3142 Horizon Rd
Suite 201
Rockwall, TX 75032-7809

Phone

(469) 757-4410

Fax

(469) 277-3911

NPI assigned

Mar 14, 2011

Last updated

Mar 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sanjay Bhambri, DONPI 1275702656

Title

President

Phone

(469) 757-4410

Specialties & licenses 1

Addresses

Other names 1

• Texas Dermatology and Skin Cancer Center, PLLC Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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.

• Sanjay Bhambri, DO

  • MOHS-Micrographic Surgery Physician
  • Rockwall, TX
  • NPI 1275702656
  Medicare reassignment Care Compare group NPD Authorized official
• Avani Bhambri, MD

  • Dermatology Physician
  • Rockwall, TX
  • NPI 1114122512
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1134427206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD",
            "address_2": "SUITE 201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327809",
            "telephone_number": "469-757-4410",
            "fax_number": "469-277-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD",
            "address_2": "SUITE 201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327809",
            "telephone_number": "469-757-4410",
            "fax_number": "469-277-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DERMATOLOGY AND SKIN CANCER CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "BHAMBRI",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-757-4410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "N7906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Dermatology and Skin Cancer Center, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Luam Mekonnen Tekle, RN, FNP-C
• Maeson Tendler
• Terrell Women's Health Center Dba WW Women's Health
• Tetsuya Hasegawa, D.C., Inc. (T Chiropractic & Acupuncture)
• Texas Care Services
• Texas First Assist, LLC.
• Texas Health Back Care (Spine Team Texas)
• Texas Health Physicians Group
• Texas Health Surgery Center Rockwall, LLC
• Texas Health Urgent Care (Texas Health Breeze Urgent Care)

• MOHS-Micrographic Surgery Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• MOHS-Micrographic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.