NPIMap

Organization Active NPI

Dallas Dermatology

Doing business as Dermatology Center of Rockwall

  • Dermatology Physician
  • Rockwall, TX
National Provider Identifier
1538436241
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
K8565 Issued in TX
Legal business name
DALLAS DERMATOLOGY
Doing business as
Dermatology Center of Rockwall
Practice address
2504 Ridge Rd
Ste. 203
Rockwall, TX 75087-2569
Phone
(972) 563-8500
Fax
(972) 563-8501
NPI assigned
Nov 23, 2011
Last updated
Nov 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Candace Walding
Title
Billing Manager
Phone
(972) 563-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X K8565 TX Primary
Procedural Dermatology Physician 207NS0135X K8565 TX

Addresses

Primary practice location

2504 Ridge Rd
Ste. 203
Rockwall, TX 75087-2569

Mailing address

763 E US Highway 80
Ste. 200
Forney, TX 75126-8633
Phone (972) 563-8500

Other names 1

  • Dermatology Center of Rockwall Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dallas Dermatology4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1538436241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 E US HIGHWAY 80",
            "address_2": "STE. 200",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268633",
            "telephone_number": "972-563-8500",
            "fax_number": "972-563-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 RIDGE RD",
            "address_2": "STE. 203",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872569",
            "telephone_number": "972-563-8500",
            "fax_number": "972-563-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "WALDING",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "BILLING  MANAGER",
        "authorized_official_telephone_number": "972-563-8500"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "K8565",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TX",
            "license": "K8565",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Center of Rockwall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.