Dermatology Center PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

95-143 Issued in NM

Legal business name

DERMATOLOGY CENTER PC

Practice address

2525 S Telshor Blvd
Building 15 Suite 200
Las Cruces, NM 88011-9148

Phone

(505) 522-3636

Fax

(505) 522-0722

NPI assigned

Oct 24, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Segal, MD

Title

President

Phone

(505) 522-3636

Specialties & licenses 1

Addresses

Other names 1

• Dermatology Center PC A new Mexico Corporation Other name

Locations

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1659361418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S TELSHOR BLVD",
            "address_2": "BUILDING 15 SUITE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880119148",
            "telephone_number": "505-522-3636",
            "fax_number": "505-522-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S TELSHOR BLVD",
            "address_2": "BUILDING 15 SUITE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880119148",
            "telephone_number": "505-522-3636",
            "fax_number": "505-522-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "SEGAL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-522-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NM",
            "license": "95-143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Center PC A new Mexico Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dermatology Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Dermatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.