Organization Active NPI

Skin Health Dermatology, PLLC

  • Dermatology Physician
  • Waco, TX
National Provider Identifier
1154013423
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SKIN HEALTH DERMATOLOGY, PLLC
Practice address
611 W State Highway 6 Ste 115
Waco, TX 76710-7545
Phone
(254) 265-7546
Fax
(254) 265-7542
NPI assigned
May 24, 2023
Last updated
May 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Dr. Ranhy Bang, PHD, MDNPI 1275739054
Title
Sole Member
Phone
(254) 265-7546

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

611 W State Highway 6 Ste 115
Waco, TX 76710-7545

Mailing address

611 W State Highway 6 Ste 115
Waco, TX 76710-7545
Phone (254) 265-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230824000179 TX Part B Supplier - Clinic/Group Practice 1456714484 Receives reassigned benefits from 1 practitioner
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Locations

611 W State Highway 6
Ste 115
Waco, TX 76710
Phone (254) 265-7546

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": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1154013423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W STATE HIGHWAY 6 STE 115",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107545",
            "telephone_number": "254-265-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W STATE HIGHWAY 6 STE 115",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767107545",
            "telephone_number": "254-265-7546",
            "fax_number": "254-265-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN HEALTH DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "BANG",
        "authorized_official_first_name": "RANHY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "254-265-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.