Organization Active NPI

Balcones Dermatology Associates, P.a.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1699044800
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
L6307 Issued in TX
Legal business name
BALCONES DERMATOLOGY ASSOCIATES, P.A.
Practice address
7800 N. Mo Pac Expwy,
Ste 315
Austin, TX 78759
Phone
(512) 459-4869
Fax
(512) 453-2795
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
David A Bushore, M.D.NPI 1568461036
Title
President, Owner
Phone
(512) 459-4869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X L6307 TX Primary

Addresses

Primary practice location

7800 N. Mo Pac Expwy,
Ste 315
Austin, TX 78759

Mailing address

7800 N. Mo Pac Expwy,
Ste 315
Austin, TX 78759
Phone (512) 459-4869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120510000134 TX Part B Supplier - Clinic/Group Practice 3779745609 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

8240 N Mopac Expy
Ste 350
Austin, TX 78759
Phone (512) 459-4869

Practitioners & affiliated clinicians

Practitioners 5

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": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1699044800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 N. MO PAC EXPWY,",
            "address_2": "STE 315",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "512-459-4869",
            "fax_number": "512-453-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N. MO PAC EXPWY,",
            "address_2": "STE 315",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "512-459-4869",
            "fax_number": "512-453-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALCONES DERMATOLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "BUSHORE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "512-459-4869",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L6307",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 27, 2026; 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.