Individual provider Active NPI

William David Boothe Jr., M.D.

  • Dermatology Physician
  • Lubbock, TX
National Provider Identifier
1649711904
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R9043 Issued in TX
Practice address
3601 22ND St
Lubbock, TX 79410-1399
Phone
(806) 796-7193
Fax
(806) 796-0034
NPI assigned
Mar 19, 2017
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X R9043 TX Primary

Addresses

Primary practice location

3601 22ND St
Lubbock, TX 79410-1399

Mailing address

4608 93Rd St
Lubbock, TX 79424-5012
Phone (806) 789-0553

Other practice location 1

4608 93rd St
Lubbock, TX 79424
Phone (806) 789-0553

Other practice location 2

3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-1832

Other practice location 3

4608 93rd St
Lubbock, TX 79424
Phone (806) 789-0553

Other practice location 4

5103 98th St Ste 200
Lubbock, TX 79424-7784
Phone (806) 796-7193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725003173 TX Practitioner - Dermatology 4284909722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock Dermatology and Skin Cancer CenterGroup PAC ID 9032128053, 7 clinicians

Practice addresses (Care Compare)

3601 22ND St
Lubbock, TX 79410-1309
Phone (806) 796-7193

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.89 of 100Reported as individual
Quality
87.36
Promoting interoperability
99
Improvement activities
40
Cost
76.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions732
Removal of skin cancer30
Removal or shaving of skin growth1-10
Skin biopsy263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock Dermatology and Skin Cancer Center Dermatology CurrentSince Jul 1, 2025 Accepting new patients

Locations

3601 22nd St
Lubbock, TX 79410
Phone (806) 796-7193

5103 98th St
Ste 200
Lubbock, TX 79424
Phone (806) 796-7193

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1649711904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 93RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245012",
            "telephone_number": "806-789-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101399",
            "telephone_number": "806-796-7193",
            "fax_number": "806-796-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4608 93rd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "79424",
            "country_code": "US",
            "telephone_number": "806-789-0553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-1832",
            "fax_number": "806-743-1105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4608 93rd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "79424",
            "country_code": "US",
            "telephone_number": "806-789-0553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5103 98th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794247784",
            "country_code": "US",
            "telephone_number": "806-796-7193",
            "fax_number": "806-796-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-19",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R9043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.