South Tyler Dermatology

Primary specialty

SpecialistTaxonomy code 174400000X

License

H2238 Issued in TX

Legal business name

SOUTH TYLER DERMATOLOGY

Practice address

5791 Copeland Rd
Tyler, TX 75703-3905

Phone

(903) 509-2020

Fax

(903) 509-2355

NPI assigned

Jul 16, 2007

Last updated

Jul 16, 2007By 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

Dr. Dannise Beckley, M.DNPI 1205837424

Title

Physcian/ Owner

Phone

(903) 509-2020

Specialties & licenses 1

Addresses

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.

• Dannise Beckley, M.D.

  • Specialist
  • Tyler, TX
  • NPI 1205837424
  Authorized official Same address or phone

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1568661908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5791 COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-509-2020",
            "fax_number": "903-509-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5791 COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-509-2020",
            "fax_number": "903-509-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TYLER DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "BECKLEY",
        "authorized_official_first_name": "DANNISE",
        "authorized_official_title_or_position": "PHYSCIAN/ OWNER",
        "authorized_official_telephone_number": "903-509-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "H2238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Sorto, M.D.
• Brianna Souder, DO
• South Limestone Hospital District (Briarcliff Health Center)
• South Limestone Hospital District (Providence Park Rehabilitation and Skilled Nursing)
• South Park Care & Rehab LLC
• South Tyler Family Dentistry PLLC (Fresh Dental and Orthodontics)
• Southland Legend Pharmacy
• Southwest LTC - Reunion Plaza LLC (Reunion Plaza Healthcare & Rehabilitation)
• Southwest LTC - Waterton LLC (The Waterton Healthcare & Rehabilitation)
• Stephen C Spain, MD

• Specialist in Tyler, TX
• Providers in Tyler, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.