Organization Active NPI

Nassau Bay Dermatology PA

  • Dermatology Physician
  • Webster, TX
National Provider Identifier
1194923599
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NASSAU BAY DERMATOLOGY PA
Practice address
390 E Medical Center Blvd
Webster, TX 77598-4321
Phone
(281) 286-4455
Fax
(281) 286-3366
NPI assigned
Jul 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Jeanne A Paz, MDNPI 1700884210
Title
Owner
Phone
(281) 286-4455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

390 E Medical Center Blvd
Webster, TX 77598-4321

Mailing address

390 E Medical Center Blvd
Webster, TX 77598-4321
Phone (281) 286-4455

Other identifiers 1

IdentifierTypeStateIssuer
123936001MedicaidTX

National Provider Directory

National Provider Directory

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": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1194923599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984321",
            "telephone_number": "281-286-4455",
            "fax_number": "281-286-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984321",
            "telephone_number": "281-286-4455",
            "fax_number": "281-286-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU BAY DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "PAZ",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-286-4455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123936001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.