Keller Dermatology, P.a.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

F6536 Issued in TX

Legal business name

KELLER DERMATOLOGY, P.A.

Practice address

601 S Main St
Suite 115
Keller, TX 76248-7029

Phone

(817) 753-6633

Fax

(817) 753-6634

NPI assigned

Jun 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jack B Cohen, D.O.

Title

President

Phone

(817) 753-6633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1276387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276387200000",
    "number": "1588985683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST",
            "address_2": "SUITE 115",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487029",
            "telephone_number": "817-753-6633",
            "fax_number": "817-753-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST",
            "address_2": "SUITE 115",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487029",
            "telephone_number": "817-753-6633",
            "fax_number": "817-753-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-13",
        "last_updated": "2010-06-13",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-753-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "F6536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Leath LLC (playworks counseling)
• Taleah Ashlyn Keesee
• Kara Keith, PT
• Keller Cosmetics (Dr Misty J Brown)
• Keller Dentistry LLC (The Dok - Dentist of Keller)
• Keller Disc and Spine, PLLC
• Keller Family Chiropractic P.C.
• Keller Family Dental PLLC
• Keller Family Dentistry, Sleep & Facial Pain PLLC (Keller Family Dentistry, Sleep & Facial Pain)
• Keller Family Medical Center, PLLC

• Medical Specialty Clinic/Center in Keller, TX
• Providers in Keller, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2010; 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.