NPIMap

Organization Active NPI

Balcones Dermatology Associates, PA

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1407855646
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BALCONES DERMATOLOGY ASSOCIATES, PA
Practice address
8240 N Mopac Expy
Ste 350
Austin, TX 78759-8840
Phone
(512) 459-4869
Fax
(512) 453-2795
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Katherine K Farady, MDNPI 1174522791
Title
President
Phone
(512) 459-4869

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 TX Primary

Addresses

Primary practice location

8240 N Mopac Expy
Ste 350
Austin, TX 78759-8840

Mailing address

8240 N Mopac Expy
Ste 350
Austin, TX 78759-8840
Phone (512) 459-4869

Other identifiers 2

IdentifierTypeStateIssuer
00083KOtherTXBCBS
079816701MedicaidTX

National Provider Directory

National Provider Directory

Locations

7800 N Mopac Expy
Ste 315
Austin, TX 78759
Phone (512) 459-4869

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407855646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 N MOPAC EXPY",
            "address_2": "STE 350",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598840",
            "telephone_number": "512-459-4869",
            "fax_number": "512-453-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 N MOPAC EXPY",
            "address_2": "STE 350",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598840",
            "telephone_number": "512-459-4869",
            "fax_number": "512-453-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALCONES DERMATOLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FARADY",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-459-4869",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00083K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079816701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.