Victoria Dermatology, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

VICTORIA DERMATOLOGY, PA

Practice address

115 Medical Dr Ste 202
Victoria, TX 77904-3106

Phone

(281) 836-4690

Fax

(409) 729-2449

NPI assigned

Oct 31, 2022

Last updated

Dec 6, 2022By 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

Amit Patel, MDNPI 1346553120

Title

President

Phone

(281) 836-4690

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

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.

• Amit M. Patel, M.D.

  • Dermatology Physician
  • Port Arthur, TX
  • NPI 1346553120
  Medicare reassignment Care Compare group NPD Authorized official
• Eugen Stancut, MD

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1356508352
  Medicare reassignment Care Compare group NPD
• Clayton Jefferson Pete Wilkerson, PA-C

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1952181612
  Medicare reassignment Care Compare group NPD
• Vivek Oza, PA-C

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1245847581
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1316654221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR STE 202",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043106",
            "telephone_number": "281-836-4690",
            "fax_number": "409-729-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR STE 202",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043106",
            "telephone_number": "281-836-4690",
            "fax_number": "409-729-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-836-4690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria City-County Health Department
• Victoria County (HARP of Victoria)
• Victoria County
• Victoria Dental Assoicates
• Victoria Dentistry, PLLC (Smile Structure)
• Victoria Ed (Victoria ER)
• Victoria Electrocardiography (Victoria EKG)
• Victoria Emergency Associates
• Victoria Emergency Associates LLC
• Victoria ENT Associates, LLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.