Sweetwater Dermatology PLLC
Organization Active NPI Dermatology Physician · Sugar Land, TX
NPI 1851058010 · NPPES record last updated Nov 23, 2021
Key facts
- NPI
- 1851058010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- SWEETWATER DERMATOLOGY PLLC
- Practice address
- 3533 Town Center Blvd S Ste 200
Sugar Land, TX 77479-1456 - Phone
- (281) 912-3425
- NPI assigned
- Nov 23, 2021
- Organization subpart
- No
Authorized official
- Name
- Sunaina Bhuchar Likhari, MD
- Title
- Owner
- Phone
- (281) 912-3425
Practitioners 1
-
Sunaina Bhuchar Likhari, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2256058 | Sweetwater Dermatology PLLC | Provider-performed microscopy | Mar 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220301000329 | TX | Part B Supplier - Clinic/Group Practice | 7810381282 |
Receives reassigned benefits from 1 practitioner Practice locations: Sugar Land, TX |
National Provider Directory
Locations
3533 Town Center Blvd S
Ste 200
Sugar Land, TX 77479
Phone (281) 240-3338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
3533 Town Center Blvd S Ste 200
Sugar Land, TX 77479-1456
Mailing address
3533 Town Center Blvd S Ste 200
Sugar Land, TX 77479-1456
Phone (281) 912-3425
Other providers in Sugar Land, TX
- Swarna Balasubramaniam MD
- Tammy Sweed
- Sweeny Hospital District
- Sweet Water Emergency Physicians PLLC
- Sweetwater Clinic
- Sweetwater Medical Associates, PLLC
- Sweetwater MRI LP
- Sweetwater OBGYN Associates LTD., LLP
- Sweetwater Pharmacy PLLC
- Sweetwater Radiology Associates LLP
All providers in Sugar Land, TX · Dermatology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.