Lakewood Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

Q6655 Issued in TX

Legal business name

LAKEWOOD DERMATOLOGY, PLLC

Practice address

6162 E Mockingbird LN
Ste. 120
Dallas, TX 75214-2697

Phone

(214) 463-8328

NPI assigned

Mar 11, 2016

Organization subpart

No

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

Authorized official

Name

Patrick Henry McDonough, MDNPI 1023374519

Title

President

Phone

(214) 463-8328

Specialties & licenses 1

Addresses

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 1

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

• Patrick Henry McDonough

  • Dermatology Physician
  • Dallas, TX
  • NPI 1023374519
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1780045260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6162 E MOCKINGBIRD LN",
            "address_2": "STE. 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142697",
            "telephone_number": "214-463-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6162 E MOCKINGBIRD LN",
            "address_2": "STE. 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142697",
            "telephone_number": "214-463-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "MCDONOUGH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-463-8328",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q6655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeview ENT, PA
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• Lakeview Primary Homecare LLC
• Lakewood Anesthesia, PLLC
• Lakewood Dental Studio PLLC
• Lakewood Emergency Room
• Lakewood Imaging Associates, LLC
• Lakewood Integrative Health & Wellness, PLLC
• Lakewood Iom
• Lakewood Orthopaedics & Sports Medicine, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.