Active NPI
Magnolia Dermatology
- Dermatology Physician
- Cypress, TX
National Provider Identifier
1235890807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- MAGNOLIA DERMATOLOGY
- Practice address
- 10547 Fry Road
Cypress, TX 77433 - Phone
- (832) 834-3349
- Fax
- (832) 281-0218
- NPI assigned
- Jan 6, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Samantha Jane Robare, M.D.
- Title
- Owner
- Phone
- (832) 834-3349
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
10547 Fry Road
Cypress, TX 77433
Mailing address
10547 Fry Road
Cypress, TX 77433
Phone (832) 834-3349
Other names 1
- Magnolia Dermatology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10547 Fry Rd
Cypress, TX 77433
Phone (832) 834-3349
Interoperability endpoints
- https://app.meldrx.com/api/fhir/ez_00193
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Cypress, TX
- NPI 1306161211
-
- Dermatology Physician
- Cypress, TX
- NPI 1245843473
-
- Physician Assistant
- Katy, TX
- NPI 1164820940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683504000000",
"number": "1235890807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10547 FRY ROAD",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77433",
"telephone_number": "832-834-3349",
"fax_number": "832-281-0218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10547 FRY ROAD",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77433",
"telephone_number": "832-834-3349",
"fax_number": "832-281-0218"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGNOLIA DERMATOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-06",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A",
"authorized_official_last_name": "ROBARE",
"authorized_official_first_name": "SAMANTHA",
"authorized_official_middle_name": "JANE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "832-834-3349",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Magnolia Dermatology",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Magnolia Dermatology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cypress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.