Southwest Skin and Vein Center PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

Q3000 Issued in TX

Legal business name

SOUTHWEST SKIN AND VEIN CENTER PLLC

Practice address

4544 S Lamar Blvd Ste 640
Austin, TX 78745-1500

Phone

(512) 444-7208

Fax

(512) 444-2343

NPI assigned

Jul 25, 2015

Organization subpart

No

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

Authorized official

Name

Michael GravesNPI 1770880007

Title

Owner MD

Phone

(512) 444-7208

Specialties & licenses 1

Addresses

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

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Graves, MD

  • MOHS-Micrographic Surgery Physician
  • Austin, TX
  • NPI 1770880007

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Mark Correa, M.D.

  • Dermatology Physician
  • Austin, TX
  • NPI 1962864488
  Medicare reassignment Care Compare group NPD
• Clark Gravell, MD

  • Dermatology Physician
  • Austin, TX
  • NPI 1518545961
  Medicare reassignment Care Compare group NPD
• Peter Josef Gust

  • Dermatology Physician
  • Manor, TX
  • NPI 1316488513
  Medicare reassignment Care Compare group NPD
• Connor Thomas Hughes

  • Dermatology Physician
  • Austin, TX
  • NPI 1750916045
  Medicare reassignment Care Compare group NPD
• Riddell Walcott Scott, M.D.

  • Dermatology Physician
  • Austin, TX
  • NPI 1881708139
  Medicare reassignment Care Compare group NPD
• Leigha Sharp, MD

  • Dermatology Physician
  • Austin, TX
  • NPI 1386091288
  Medicare reassignment Care Compare group NPD
• Brenda Watkins, MD

  • Dermatology Physician
  • Dripping Springs, TX
  • NPI 1871904607
  Medicare reassignment Care Compare group NPD
• Jamie B Raisor, ARNP

  • Nurse Practitioner
  • Lagrange, GA
  • NPI 1235392424

  TX

  Medicare reassignment
• Marcia Lea O'Brien, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1053853176
  NPD
• Dustin Allen Fontenot, P.A.

  • Physician Assistant
  • Round Rock, TX
  • NPI 1508046715
  NPD (past)
• Lucas Jacomides, MD

  • Urology Physician
  • Round Rock, TX
  • NPI 1750381620
  NPD (past)

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

{
    "created_epoch": "1437782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768608000000",
    "number": "1609251107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4544 S LAMAR BLVD STE 640",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451500",
            "telephone_number": "512-444-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4544 S LAMAR BLVD STE 640",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451500",
            "telephone_number": "512-444-7208",
            "fax_number": "512-444-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4419 Frontier Trl",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787451686",
            "country_code": "US",
            "telephone_number": "512-444-7208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHWEST SKIN AND VEIN CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-25",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER MD",
        "authorized_official_telephone_number": "512-444-7208"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q3000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Key
• Southwest LTC - Austin Alf, LLC (Colonial Gardens of Austin A-2)
• Southwest LTC - Austin Alf, LLC (Colonial Gardens of Austin A-1)
• Southwest Neuropsychiatry Association PLLC (TMS of Austin)
• Southwest Skin & Cancer Clinic, P.a.
• Southwest Surgical Operating Company, LLC (Advanced Surgical Center - Austin)
• Southwest Surgical Systems, Inc.
• Southwestern Colon & Rectal Surgery, PA
• Southwood Care Center LLC
• Kourtney Souza

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2026; 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.