Organization Active NPI

Dermatology Associates Inc

  • Dermatology Physician
  • Corpus Christi, TX
National Provider Identifier
1669610713
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D4148 Issued in TX
Legal business name
DERMATOLOGY ASSOCIATES INC
Doing business as
BEVERLY L HELD MD
Practice address
5756 S Staples St Ste J2
Corpus Christi, TX 78413-3782
Phone
(361) 993-3193
Fax
(361) 993-3800
NPI assigned
Jan 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Authorized official

Name
Mr. Justin C Holloway
Title
Business Manager
Phone
(361) 993-3193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X D4148 TX Primary

Addresses

Primary practice location

5756 S Staples St Ste J2
Corpus Christi, TX 78413-3782

Mailing address

5756 S Staples St Ste J2
Corpus Christi, TX 78413-3782
Phone (361) 993-3193

Other identifiers 3

IdentifierTypeStateIssuer
00N148OtherTXMEDICARE PROVIDER #
071900011OtherTXMEDICARE RAILROAD
H0021412OtherTXTEXAS CONTROLLED SUBSTANCES

Other names 1

  • BEVERLY L HELD MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000464 TX Part B Supplier - Clinic/Group Practice 2264600584 Receives reassigned benefits from 1 practitioner
Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

5756 S Staples St
Ste J2
Corpus Christi, TX 78413
Phone (361) 993-3190

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1669610713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5756 S STAPLES ST STE J2",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133782",
            "telephone_number": "361-993-3193",
            "fax_number": "361-993-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5756 S STAPLES ST STE J2",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133782",
            "telephone_number": "361-993-3193",
            "fax_number": "361-993-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "361-993-3193",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "D4148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "00N148",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "071900011",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CONTROLLED SUBSTANCES",
            "identifier": "H0021412",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEVERLY L HELD MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.