Organization Active NPI

United Dermatology Associates of Arlington, PLLC

Doing business as United Dermatology Associates, PLLC

  • Dermatology Physician
  • Arlington, TX
National Provider Identifier
1386228930
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
UNITED DERMATOLOGY ASSOCIATES OF ARLINGTON, PLLC
Doing business as
United Dermatology Associates, PLLC
Practice address
3132 Matlock Rd Ste 307
Arlington, TX 76015-2922
Phone
(817) 539-0959
Fax
(817) 207-4188
NPI assigned
May 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Authorized official

Name
Jeannine K Hoang, MDNPI 1578513933
Title
Owner
Phone
(817) 261-1122

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)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3132 Matlock Rd Ste 307
Arlington, TX 76015-2922

Mailing address

130 Regency Pkwy
Mansfield, TX 76063-5167
Phone (817) 261-1122

Other names 1

  • United Dermatology Associates, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210628000256 TX Part B Supplier - Clinic/Group Practice 3476954561 Receives reassigned benefits from 13 practitioners
Practice locations: Arlington, TX; Palestine, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2231239United Dermatology Associates of Arlington PLLC3132 Matlock Rd Ste 307, Arlington, TX 76015Provider-performed microscopyJul 30, 2027

National Provider Directory

National Provider Directory

Locations

400 N Queen St
Palestine, TX 75801

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1386228930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 REGENCY PKWY",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635167",
            "telephone_number": "817-261-1122",
            "fax_number": "817-207-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 MATLOCK RD STE 307",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152922",
            "telephone_number": "817-539-0959",
            "fax_number": "817-207-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DERMATOLOGY ASSOCIATES OF ARLINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-261-1122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Dermatology Associates, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.