NPIMap

Organization Active NPI

Innovative Dermatology P a

  • Dermatology Physician
  • Plano, TX
National Provider Identifier
1417238999
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N3612 Issued in TX
Legal business name
INNOVATIVE DERMATOLOGY P A
Practice address
5425 W Spring Creek Pkwy
Suite 265
Plano, TX 75024-4236
Phone
(214) 919-3500
Fax
(214) 919-3501
NPI assigned
Aug 29, 2011
Last updated
Aug 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Authorized official

Name
Seemal R Desai, MDNPI 1669686804
Title
Owner
Phone
(214) 919-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X N3612 TX Primary

Addresses

Primary practice location

5425 W Spring Creek Pkwy
Suite 265
Plano, TX 75024-4236

Mailing address

5425 W Spring Creek Pkwy
Suite 265
Plano, TX 75024-4236
Phone (214) 919-3500

National Provider Directory

National Provider Directory

Locations

5425 W Spring Creek Pkwy
Ste 265
Plano, TX 75024
Phone (214) 919-3500

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1417238999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 265",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "214-919-3500",
            "fax_number": "214-919-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 265",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "214-919-3500",
            "fax_number": "214-919-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DERMATOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "SEEMAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-919-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.