Alliance Dermatology, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

M1267 Issued in TX

Legal business name

ALLIANCE DERMATOLOGY, PC

Practice address

5425 Matlock Rd
Suite # 102
Arlington, TX 76018-1557

Phone

(817) 200-7498

NPI assigned

Dec 22, 2009

Last updated

Dec 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tri M Nguyen, M.D.NPI 1003952086

Title

Owner/Physician

Phone

(817) 200-7498

Specialties & licenses 1

Addresses

Other names 1

• TRI M. NGUYEN, M.D. Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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.

• Tri Minh Nguyen, M.D.

  • Dermatology Physician
  • Arlington, TX
  • NPI 1003952086
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1851620892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 MATLOCK RD",
            "address_2": "SUITE # 102",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181557",
            "telephone_number": "817-200-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 MATLOCK RD",
            "address_2": "SUITE # 102",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181557",
            "telephone_number": "817-200-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TRI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "817-200-7498",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "M1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRI M. NGUYEN, M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinic/Center in Arlington, TX
• Providers in Arlington, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.