Radiant Dermatology Fall Creek PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RADIANT DERMATOLOGY FALL CREEK PLLC

Practice address

9240 N Sam Houston Pkwy E
Ste 201
Humble, TX 77396

Phone

(832) 777-7559

Fax

(832) 777-7541

NPI assigned

Dec 12, 2019

Organization subpart

No

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

Authorized official

Name

Liet Le, MD

Title

Owner/Provider

Phone

(832) 777-7559

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1821636564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 N SAM HOUSTON PKWY E",
            "address_2": "STE 201",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77396",
            "telephone_number": "832-777-7559",
            "fax_number": "832-777-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 N SAM HOUSTON PKWY E",
            "address_2": "STE 201",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77396",
            "telephone_number": "832-777-7559",
            "fax_number": "832-777-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT DERMATOLOGY FALL CREEK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "LIET",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "832-777-7559",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Raabe, MS CCC-SLP
• Srikanth Krishnamurthy Raayasa, MD
• Tanya Nicole Rachan, DMD
• Shirley Radford, DDS
• Radhikasmiles PLLC
• Bailey Raines
• Tawakalitu Raji, PMHNP
• Rajiv Agarwal MD PA
• Rajiv Agarwal MD PA
• Bettina Rachel Raju

• Dermatology Physician in Humble, TX
• Providers in Humble, 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 12, 2019; 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.