Organization Active NPI

The Woodlands Dermatology Associates PA

  • Dermatology Physician
  • The Woodlands, TX
National Provider Identifier
1619919958
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
THE WOODLANDS DERMATOLOGY ASSOCIATES PA
Practice address
9303 Pinecroft Dr
Suite 150
The Woodlands, TX 77380-3181
Phone
(281) 363-5050
Fax
(281) 363-5020
NPI assigned
Jun 12, 2006
Last updated
Mar 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Authorized official

Name
Dr. Leslie S Ledbetter, M.D.NPI 1477518538
Title
Owner Partner
Phone
(281) 363-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

9303 Pinecroft Dr
Suite 150
The Woodlands, TX 77380-3181

Mailing address

9303 Pinecroft Dr
Suite 150
The Woodlands, TX 77380-3181
Phone (281) 363-5050

Other identifiers 1

IdentifierTypeStateIssuer
00226VOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001445 TX Part B Supplier - Clinic/Group Practice 0042202947 Receives reassigned benefits from 16 practitioners
Practice locations: The Woodlands, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1012429Woodlands Dermatology Associates,PA, the9303 Pinecroft Dr, Suite 150, The Woodlands, TX 77380Provider-performed microscopyMay 11, 2027
45D2058539The Woodlands Dermatology Associates9303 Pinecroft Ste 160, The Woodlands, TX 77380ComplianceApr 5, 2027
45D2231650Woodlands Dermatology Associates, the9303 Pinecroft Dr, Suite 100, The Woodlands, TX 77380ComplianceSep 22, 2026

National Provider Directory

National Provider Directory

Locations

21300 Eva St
Ste 200
Montgomery, TX 77356

9303 Pinecroft Dr
Ste 150
The Woodlands, TX 77380
Phone (281) 363-5050

9303 Pinecroft Dr
Ste 160
The Woodlands, TX 77380
Phone (281) 363-5050

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1619919958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9303 PINECROFT DR",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803181",
            "telephone_number": "281-363-5050",
            "fax_number": "281-363-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9303 PINECROFT DR",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803181",
            "telephone_number": "281-363-5050",
            "fax_number": "281-363-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WOODLANDS DERMATOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "281-363-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00226V",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.