K Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P3746 Issued in TX

Legal business name

K DERMATOLOGY PLLC

Doing business as

K Dermatology & Wellness Institute

Practice address

399 W Campbell Rd Ste 410
Richardson, TX 75080-3636

Phone

(972) 469-3376

Fax

(972) 469-3288

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Angie Koriakos, D.O.NPI 1396060794

Title

Owner

Phone

(972) 469-3376

Specialties & licenses 1

Addresses

Other names 1

• K Dermatology & Wellness Institute Doing business as

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

Practitioners 2

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.

• Angie Koriakos, DO

  • Dermatology Physician
  • Richardson, TX
  • NPI 1396060794
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Davis Stewart, PA-C

  • Medical Physician Assistant
  • Richardson, TX
  • NPI 1477782761
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1386195204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803636",
            "telephone_number": "972-469-3376",
            "fax_number": "972-469-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803636",
            "telephone_number": "972-469-3376",
            "fax_number": "972-469-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "KORIAKOS",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-469-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P3746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "K Dermatology & Wellness Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jung I CHI MD PA
• Young-Jee Jung, MD
• Hortensia Jurado, FNP
• Shannon Kay Justema
• Michelle Justiss, MS CCC-SLP
• Mohamad Kabach, M.D
• Kaheri Medical PLLC
• Kai Davis Prosthetics LLC
• Kaiser Medical Partners LLC
• Kalibra Home Care

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.