Central Texas Dermatology, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

F4405 Issued in TX

Legal business name

CENTRAL TEXAS DERMATOLOGY, PA

Practice address

102 Westlake Dr
#100
West Lake Hills, TX 78746

Phone

(512) 327-7779

NPI assigned

Feb 20, 2007

Last updated

Sep 13, 2023By 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

Mrs. Debra Petrie, BILLER

Title

Biller/Credentialer

Phone

(512) 327-8449

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 13

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.

• Olivia Mei Chen, MD

  • MOHS-Micrographic Surgery Physician
  • West Lake Hills, TX
  • NPI 1689102527
  Medicare reassignment Care Compare group NPD
• Lia Giannotti Stratton, FNP-C

  • Dermatology Physician
  • West Lake Hills, TX
  • NPI 1972045987
  Medicare reassignment Care Compare group NPD
• Alison Messer, MD

  • Dermatology Physician
  • Austin, TX
  • NPI 1598129975
  Medicare reassignment Care Compare group NPD
• Emma H Weiss

  • Dermatology Physician
  • Aurora, CO
  • NPI 1801390224

  TX

  Medicare reassignment Care Compare group NPD
• Mellissa Binney, P.A.

  • Medical Physician Assistant
  • Austin, TX
  • NPI 1861480881
  Medicare reassignment Care Compare group
• Halliday Craige McDonald, M.D.

  • Dermatology Physician
  • West Lake Hills, TX
  • NPI 1285835603
  Medicare reassignment Care Compare group
• Emily Liga Prosise, MD

  • Dermatology Physician
  • West Lake Hills, TX
  • NPI 1548272065
  Medicare reassignment Care Compare group
• Jeffrey D Cone Jr., M.D.

  • Plastic Surgery Physician
  • Austin, TX
  • NPI 1194912469
  Medicare reassignment NPD
• Zoltan Trizna, MD

  • Dermatology Physician
  • West Lake Hills, TX
  • NPI 1619056827
  Medicare reassignment NPD
• Caedran Peete, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Topeka, KS
  • NPI 1811413842

  TX

  Medicare reassignment
• Lilian Nicole Machuca, APRN

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1184866790
  NPD
• Clayton Jefferson Pete Wilkerson, PA-C

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1952181612
  NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1164566246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WESTLAKE DR",
            "address_2": "STE 100",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465373",
            "telephone_number": "512-327-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WESTLAKE DR",
            "address_2": "#100",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-327-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "BILLER/CREDENTIALER",
        "authorized_official_telephone_number": "512-327-8449",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BILLER"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dodie Sides Cashell, M.S., CCC-SLP
• Maritza Castaneda, M.S., SLP
• Rita Maddalena Castriotta, D.C.
• Angel Anthony Castro
• Center for Cosmetic Dentistry West Austin
• Central Texas Rhuematology P.a.
• Central Texas Surgical Assist, L.L.C.
• Eduardo J. Cepeda, M.D.
• Carissa Cerda, PH.D.
• Chasee Suzanne Chappell Hudgins, PSY.D.

• Specialist in West Lake Hills, TX
• Providers in West Lake Hills, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.