Medica Skin Diagnostics PLLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

K8136 Issued in TX

Legal business name

MEDICA SKIN DIAGNOSTICS PLLC

Practice address

2046 Bedford Rd
Bedford, TX 76021-5709

Phone

(936) 443-7504

NPI assigned

Nov 18, 2015

Last updated

Nov 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lydia Essary, M.D.

Title

Owner

Phone

(936) 443-7504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1467826131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 COLLEGE ST S",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482316",
            "telephone_number": "936-443-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 BEDFORD RD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215709",
            "telephone_number": "936-443-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICA SKIN DIAGNOSTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "ESSARY",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-443-7504",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "K8136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatopathology Physician in Bedford, TX
• Providers in Bedford, TX by specialty
• Dermatopathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.