Texas Dermatology Center PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M6125 Issued in TX

Legal business name

TEXAS DERMATOLOGY CENTER PLLC

Practice address

1900 Scenic Dr Ste 2208
Georgetown, TX 78626-7703

Phone

(512) 868-9800

Fax

(512) 868-9811

NPI assigned

Jul 4, 2010

Last updated

Jul 23, 2019By 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. Mary Evers, D.O.NPI 1053533026

Title

Owner

Phone

(440) 796-3231

Specialties & licenses 1

Addresses

Locations

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.

• Mary A Evers, DO

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1053533026
  Authorized official Same address or phone

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

{
    "created_epoch": "1278201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1154633303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR STE 2208",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267703",
            "telephone_number": "512-868-9800",
            "fax_number": "512-868-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR STE 2208",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267703",
            "telephone_number": "512-868-9800",
            "fax_number": "512-868-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DERMATOLOGY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-04",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "EVERS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-796-3231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M6125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.