Dermatology of East Texas PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY OF EAST TEXAS PA

Practice address

909 Ese Loop323 Ste 110
Tyler, TX 75701-9675

Phone

(903) 531-2850

Fax

(903) 531-2875

NPI assigned

Aug 1, 2013

Last updated

Jun 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kyle David Jenkins

Title

Coo

Phone

(903) 531-2850

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

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.

• Kandiss Elizabeth Hearn, APRN, FNP-C

  • Nurse Practitioner
  • Tyler, TX
  • NPI 1336774405
  Medicare reassignment Care Compare group NPD
• Alexandra Steele Jenkins, MD

  • Dermatology Physician
  • Tyler, TX
  • NPI 1912565193
  Medicare reassignment Care Compare group NPD
• Megan M. Brown, MD

  • Dermatology Physician
  • Tyler, TX
  • NPI 1386087617
  Medicare reassignment NPD
• Stephanie Ann Davis, FNP

  • Nurse Practitioner
  • McKinney, TX
  • NPI 1497362198
  Medicare reassignment NPD
• Lisa Renee Lowry, MD

  • Dermatology Physician
  • Tyler, TX
  • NPI 1326072653
  Medicare reassignment NPD

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1679905673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E SE LOOP 323 STE 110",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019675",
            "telephone_number": "903-531-2850",
            "fax_number": "903-531-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ESE LOOP323 STE 110",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019675",
            "telephone_number": "903-531-2850",
            "fax_number": "903-531-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF EAST TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "903-531-2850"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentistry of Texas, PC
• Samantha P Denton, PA-C
• Department of State Health Services (Texas DSHS - HSR 4&5 Tyler)
• Dept of Assistive & Rehab Serv - Tyler Field Headquarters
• Dermatology and Laser Center of Tyler, P.a.
• Kadeja Derrick
• Yagnesh Kanti Desai, MD
• Marianne Deshaies
• Andre Deshong, LCDC
• Amy Michelle Deshotel, MS, CCC/SLP

• Dermatology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.