Medical & Surgical Dermatology Center of Northeast Texas, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

J9067 Issued in TX

Legal business name

MEDICAL & SURGICAL DERMATOLOGY CENTER OF NORTHEAST TEXAS, P.A.

Practice address

108 Pleasant St
Mt Pleasant, TX 75455-5322

Phone

(903) 577-8878

Fax

(903) 577-8936

NPI assigned

Sep 14, 2006

Last updated

Aug 9, 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

Dr. Anthony V Greco, M.D.NPI 1427058619

Title

Owner

Phone

(903) 577-8878

Specialties & licenses 1

Addresses

Other identifiers 2

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 3

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.

• Anthony V Greco, M.D., F.A.A.D.

  • MOHS-Micrographic Surgery Physician
  • Mount Pleasant, TX
  • NPI 1427058619

  Dermatology

  Medicare reassignment NPD Authorized official
• Denis Adams, PAC

  • Physician Assistant
  • Longview, TX
  • NPI 1174501811
  NPD
• Stephen John Beck, MD

  • MOHS-Micrographic Surgery Physician
  • Tyler, TX
  • NPI 1063490472
  NPD

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1255436135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PLEASANT ST",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754555322",
            "telephone_number": "903-577-8878",
            "fax_number": "903-577-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PLEASANT ST",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754555322",
            "telephone_number": "903-577-8878",
            "fax_number": "903-577-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL & SURGICAL DERMATOLOGY CENTER OF NORTHEAST TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-577-8878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "J9067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "45ER",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081422001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy A. (Al) McGinnis, LPC
• Shelly Ruth McIntyre
• J. Morris McKellar, M.D.
• Shonda Renee McNeil, PTA
• Med Southwest, PLLC (MyEyeDr.)
• Medical Doctor Assoc, Inc.
• Medical Plaza Cardiology
• Oghenetega Mirella Meir, PMHNP-BC
• Paul O Meriwether, M.D.
• Minadeo Eye Center PLLC (Minadeo Eye Center)

• Dermatology Physician in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.