NPIMap

Organization Active NPI

Bellaire Dermatology Associates, P.a.

  • Medical Specialty Clinic/Center
  • Bellaire, TX
National Provider Identifier
1699735878
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
BELLAIRE DERMATOLOGY ASSOCIATES, P.A.
Practice address
6565 West Loop S
Ste. 800
Bellaire, TX 77401-3500
Phone
(713) 661-4383
Fax
(713) 661-4346
NPI assigned
Mar 23, 2006
Last updated
Apr 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Craig F Teller, M.D.NPI 1851351357
Title
President
Phone
(832) 553-2318

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
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

6565 West Loop S
Ste. 800
Bellaire, TX 77401-3500

Mailing address

6565 West Loop S
Ste. 800
Bellaire, TX 77401-3500
Phone (713) 661-4383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060829000418 TX Part B Supplier - Clinic/Group Practice 6800890146 Receives reassigned benefits from 14 practitioners
Practice locations: Bellaire, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0926680Bellaire Dermatology Associates, PA6565 West Loop South, Suite 800, Bellaire, TX 77401ComplianceFeb 18, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

6565 West Loop S
Bellaire, TX 77401
Phone (713) 661-7888

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1699735878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 WEST LOOP S",
            "address_2": "STE. 800",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013500",
            "telephone_number": "713-661-4383",
            "fax_number": "713-661-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 WEST LOOP S",
            "address_2": "STE. 800",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013500",
            "telephone_number": "713-661-4383",
            "fax_number": "713-661-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAIRE DERMATOLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "TELLER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-553-2318",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.