NPIMap

Organization Active NPI

Southeast Dermatology, P.a.

  • Dermatology Physician
  • Pasadena, TX
National Provider Identifier
1811932205
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOUTHEAST DERMATOLOGY, P.A.
Practice address
4419 Crenshaw Rd
Pasadena, TX 77504-3628
Phone
(281) 991-5944
Fax
(281) 991-6849
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Dr. Ashkan John Ghorbani, MDNPI 1851392039
Title
President
Phone
(281) 991-5944

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4419 Crenshaw Rd
Pasadena, TX 77504-3628

Mailing address

4419 Crenshaw Rd
Pasadena, TX 77504-3628
Phone (281) 991-5944

Other practice location 1

11914 Astoria Blvd Ste 570
Houston, TX 77089-6079
Phone (281) 481-0033

Other identifiers 1

IdentifierTypeStateIssuer
080342101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517000995 TX Part B Supplier - Clinic/Group Practice 5193715571 Receives reassigned benefits from 11 practitioners
Practice locations: Houston, TX; Pearland, TX; Pasadena, TX; League City, TX; Friendswood, 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
45D0686649Southeast Dermatology, PA11914 Astoria Blvd Suite 570, Houston, TX 77089ComplianceJan 12, 2028
45D0944605Southeast Dermatology, PA4419 Crenshaw Road, Pasadena, TX 77504Provider-performed microscopyApr 14, 2028

National Provider Directory

National Provider Directory

Locations

11914 Astoria Blvd
Ste 590
Houston, TX 77089
Phone (281) 481-0033

11914 Astoria Blvd
Ste 570
Houston, TX 77089
Phone (281) 481-0033

4419 Crenshaw Rd
Pasadena, TX 77504
Phone (281) 481-0033

3925 Fairmont Pkwy
#100C
Pasadena, TX 77504
Phone (281) 991-5944

Practitioners & affiliated clinicians

Practitioners 12

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1811932205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 CRENSHAW RD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043628",
            "telephone_number": "281-991-5944",
            "fax_number": "281-991-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 CRENSHAW RD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043628",
            "telephone_number": "281-991-5944",
            "fax_number": "281-991-6849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11914 Astoria Blvd Ste 570",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770896079",
            "country_code": "US",
            "telephone_number": "281-481-0033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "GHORBANI",
        "authorized_official_first_name": "ASHKAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-991-5944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080342101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.