Greer Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

N5723 Issued in TX

Legal business name

GREER DERMATOLOGY, PLLC

Practice address

1200 N Carroll Ave
Southlake, TX 76092-4512

Phone

(817) 631-0310

Fax

(817) 631-0340

NPI assigned

Sep 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Sara Heldt Greer, MDNPI 1023275963

Title

President

Phone

(817) 631-0310

Specialties & licenses 1

Addresses

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.

• Sara Heldt Greer, M.D.

  • Dermatology Physician
  • Southlake, TX
  • NPI 1023275963
  Medicare reassignment NPD Authorized official
• Andie Keller, PA-C

  • Physician Assistant
  • Austin, TX
  • NPI 1750099966
  Medicare reassignment

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1164904082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924512",
            "telephone_number": "817-631-0310",
            "fax_number": "817-631-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924512",
            "telephone_number": "817-631-0310",
            "fax_number": "817-631-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREER DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "HELDT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-631-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N5723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydjea M Green, PHD
• Latasha D Greene
• William Greenlee, DC
• Destinee Nichole Greenwell, LPC, LCDC
• Nikita Greenwood, FNP
• Sara Heldt Greer, M.D.
• William Alexander Greer
• Briana Gregoire
• Gregory B Wright DDS PA
• Stephanie Griffin, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.