Baylor W Kurtis

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

E4883 Issued in TX

Practice address

2300 Highway 365
Suite 670
Nederland, TX 77627-6256

Phone

(409) 729-2262

Fax

(409) 729-2449

NPI assigned

Jul 19, 2005

Reactivated

Apr 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1366441610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365",
            "address_2": "SUITE 670",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276256",
            "telephone_number": "409-729-2262",
            "fax_number": "409-729-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365",
            "address_2": "SUITE 670",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276256",
            "telephone_number": "409-729-2262",
            "fax_number": "409-729-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTIS",
        "first_name": "BAYLOR",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2016-11-10",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "E4883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035183501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kahtan A. Kaissi, M.D.
• Kalto Occupational
• Zainab Zamir Kayani, DO
• Kotzur Huber LLP
• KR Wellness Solutions PA
• Kyler Counseling PLLC
• Robert G. Kyler, M.A.,LPC
• Galen Edmund Lacy, DDS
• Brian Eric Lecompte, MD
• John Henry Lee, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.