Corium Ventures PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

Q8995 Issued in TX

Legal business name

CORIUM VENTURES PLLC

Practice address

8525 9TH Ave
Port Arthur, TX 77642-8023

Phone

(409) 729-2262

Fax

(409) 729-2449

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Amit Patel, MDNPI 1346553120

Title

President

Phone

(409) 729-2262

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Southeast Texas Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 8

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

• Amit M. Patel, M.D.

  • Dermatology Physician
  • Port Arthur, TX
  • NPI 1346553120
  Medicare reassignment Care Compare group NPD Authorized official
• Tara Akunna, MD

  • Dermatology Physician
  • Cypress, TX
  • NPI 1295231157
  Medicare reassignment Care Compare group NPD
• Clayton Jefferson Pete Wilkerson, PA-C

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1952181612
  Medicare reassignment Care Compare group NPD
• Brianna Michelle Koym, PA

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1912640095
  Medicare reassignment Care Compare group
• Vivek Oza, PA-C

  • Physician Assistant
  • Port Arthur, TX
  • NPI 1245847581
  Medicare reassignment
• Kristopher Gabas Dela Cruz, M.D.

  • Internal Medicine Physician
  • Nederland, TX
  • NPI 1821403809
  NPD (past)
• Oscar Olfindo Enriquez, MD

  • Internal Medicine Physician
  • Port Arthur, TX
  • NPI 1487737219
  NPD (past)
• Eugen Stancut, MD

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1356508352
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1770098261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428023",
            "telephone_number": "409-729-2262",
            "fax_number": "409-729-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428023",
            "telephone_number": "409-729-2262",
            "fax_number": "409-729-2449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Medical Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779043106",
            "country_code": "US",
            "telephone_number": "281-836-4690",
            "fax_number": "409-729-2449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORIUM VENTURES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-729-2262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q8995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1346553120",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX SEC OF STATE FILE ID",
            "identifier": "802526676",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Texas Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Complete Health Care
• Melody Coons, PHARMD
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• Marian E Cordovez-Tan, M.D.
• Country Road Emergency Physicians, PLLC
• Barbara Ann Courville, M.B.A.,LPC
• Denise Craig, FNP-C
• Dustin Kyle Craver, PT, DPT
• Bradley Alan Crawford, IDHS

• Dermatology Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.