Active NPI
Cinco Ranch Dermatology, P.a.
- Dermatology Physician
- Katy, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- P4855
- Legal business name
- CINCO RANCH DERMATOLOGY, P.A.
- Practice address
- 23050 Westheimer Pkwy
Katy, TX 77494-3596 - Phone
- (281) 394-9500
- Fax
- (281) 394-5350
- NPI assigned
- Mar 17, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kelly B Conner, M.D.
- Title
- Owner / Authorized Official
- Phone
- (281) 394-9500
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | P4855 | TX | Primary |
Addresses
Primary practice location
23050 Westheimer Pkwy
Katy, TX 77494-3596
Mailing address
23050 Westheimer Pkwy
Katy, TX 77494-3596
Phone (281) 394-9500
Other names 1
- Cinco Ranch Dermatology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2066539 | Cinco Ranch Dermatology, PA | Provider-performed microscopy | Sep 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
2643 Commercial Center Blvd
Ste B360
Katy, TX 77494
Phone (281) 891-3690
23050 Westheimer Pkwy
Katy, TX 77494
Phone (281) 394-9500
23501 Cinco Ranch Blvd
Ste H120609
Katy, TX 77494
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Katy, TX
- NPI 1801039722
-
- Dermatology Physician
- Katy, TX
- NPI 1285839084
-
- Dermatology Physician
- Katy, TX
- NPI 1033615638
-
- Dermatology Physician
- Katy, TX
- NPI 1306425277
-
- Dermatology Physician
- Katy, TX
- NPI 1649733734
-
- Dermatology Physician
- Bellaire, TX
- NPI 1184065690
-
- Physician Assistant
- Sugar Land, TX
- NPI 1770290587
-
- Dermatology Physician
- Sugar Land, TX
- NPI 1720247737
-
- Medical Physician Assistant
- Sugar Land, TX
- NPI 1710578190
-
- Dermatology Physician
- Sugar Land, TX
- NPI 1285197319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620259200000",
"number": "1780926733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23050 WESTHEIMER PKWY",
"city": "KATY",
"state": "TX",
"postal_code": "774943596",
"telephone_number": "281-394-9500",
"fax_number": "281-394-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23050 WESTHEIMER PKWY",
"city": "KATY",
"state": "TX",
"postal_code": "774943596",
"telephone_number": "281-394-9500",
"fax_number": "281-394-5350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CINCO RANCH DERMATOLOGY, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-17",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A",
"authorized_official_last_name": "CONNER",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER / AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "281-394-9500",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "TX",
"license": "P4855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Cinco Ranch Dermatology",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cinco Ranch Dermatology",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.