Evergreen Dermatology Group PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P4075 Issued in TX

Legal business name

EVERGREEN DERMATOLOGY GROUP PLLC

Doing business as

Evergreen Dermatology

Practice address

2222 Greenhouse Rd Ste 1000
Houston, TX 77084-7342

Phone

(832) 437-1763

Fax

(855) 751-8050

NPI assigned

Nov 21, 2017

Organization subpart

No

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

Authorized official

Name

Robert Lin, DONPI 1033466487

Title

Owner

Phone

(832) 437-1763

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EVERGREEN DERMATOLOGY 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

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00123

Practitioners 1

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.

• Robert Lin, DO

  • Dermatology Physician
  • Houston, TX
  • NPI 1033466487
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684022400000",
    "number": "1497269989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 GREENHOUSE RD STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847342",
            "telephone_number": "832-437-1763",
            "fax_number": "855-751-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 GREENHOUSE RD STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847342",
            "telephone_number": "832-437-1763",
            "fax_number": "855-751-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DERMATOLOGY GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2023-05-14",
        "certification_date": "2023-05-14",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-437-1763",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P4075",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "P4075",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "P4075",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVERGREEN DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EVERGREEN DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Everett
• Sujata Everett
• Tonya Marie Everett
• Tarren Everette, CD
• Everettt L Hyman Odpc
• Evergreen Healthcare Services, Inc.
• Evergreen Personal Care
• Evergreen Physiatry, PLLC
• Shlermine Aupont Everidge, MD
• Amanda Willis Everitt, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2023; 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.