NPIMap

Organization Active NPI

Dermatology Group of SL PA

  • Dermatology Physician
  • Sugar Land, TX
National Provider Identifier
1790745198
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N2268 Issued in TX
Legal business name
DERMATOLOGY GROUP OF SL PA
Practice address
15200 Southwest Fwy
Suite 150
Sugar Land, TX 77478-3845
Phone
(281) 240-4313
Fax
(281) 240-3646
NPI assigned
Mar 28, 2006
Last updated
Aug 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Edward E. Rotan Jr., M.D.
Title
Owner
Phone
(281) 240-4313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X N2268 TX Primary

Addresses

Primary practice location

15200 Southwest Fwy
Suite 150
Sugar Land, TX 77478-3845

Mailing address

15200 Southwest Fwy
Suite 150
Sugar Land, TX 77478-3845
Phone (281) 240-4313

National Provider Directory

National Provider Directory

Locations

15200 Southwest Fwy
Ste 370
Sugar Land, TX 77478
Phone (281) 240-4313

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1790745198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 SOUTHWEST FWY",
            "address_2": "SUITE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783845",
            "telephone_number": "281-240-4313",
            "fax_number": "281-240-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 SOUTHWEST FWY",
            "address_2": "SUITE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783845",
            "telephone_number": "281-240-4313",
            "fax_number": "281-240-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY GROUP OF SL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "ROTAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-240-4313",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N2268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.