NPIMap

Organization Active NPI

Southwest Skin & Cancer Clinic, P.a.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1619942182
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOUTHWEST SKIN & CANCER CLINIC, P.A.
Practice address
4419 Frontier TRL
Suite 110
Austin, TX 78745-1686
Phone
(512) 444-7208
Fax
(512) 444-2343
NPI assigned
Feb 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Stephen Douglas Houston, M.D.NPI 1548235633
Title
Owner
Phone
(512) 444-7208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

4419 Frontier TRL
Suite 110
Austin, TX 78745-1686

Mailing address

4419 Frontier TRL
Suite 110
Austin, TX 78745-1686
Phone (512) 444-7208

Other identifiers 2

IdentifierTypeStateIssuer
CG4257OtherTXMEDICARE RAILROAD
084309601MedicaidTX

National Provider Directory

National Provider Directory

Locations

4419 Frontier Trl
Ste 110
Austin, TX 78745
Phone (512) 654-8100

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1619942182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 FRONTIER TRL",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451686",
            "telephone_number": "512-444-7208",
            "fax_number": "512-444-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 FRONTIER TRL",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451686",
            "telephone_number": "512-444-7208",
            "fax_number": "512-444-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SKIN & CANCER CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-444-7208",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG4257",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084309601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.