Allustra Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ALLUSTRA DERMATOLOGY, PLLC

Practice address

1740 W 27TH St Ste 315
Houston, TX 77008-1437

Phone

(713) 868-5861

NPI assigned

Apr 19, 2022

Last updated

Nov 19, 2022By 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

Dr. Brundha Balaraman, MDNPI 1437461258

Title

Physician

Phone

(713) 868-5861

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Brundha Balaraman, M.D.

  • Dermatology Physician
  • Sugar Land, TX
  • NPI 1437461258
  Medicare reassignment Care Compare group NPD Authorized official
• Jeremiah Au, M.D.

  • Dermatology Physician
  • Houston, TX
  • NPI 1306208665
  Medicare reassignment Care Compare group NPD
• Quynh-Giao Ly Sartor, MD

  • Dermatology Physician
  • Houston, TX
  • NPI 1871971374
  Medicare reassignment Care Compare group NPD
• Jan Miller Schwartz, M.D.

  • Dermatology Physician
  • Houston, TX
  • NPI 1952403677
  NPD (past)

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668816000000",
    "number": "1881337715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 BISSONNET ST # 552",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770051451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W 27TH ST STE 315",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081437",
            "telephone_number": "713-868-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLUSTRA DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-11-19",
        "certification_date": "2022-11-19",
        "status": "A",
        "authorized_official_last_name": "BALARAMAN",
        "authorized_official_first_name": "BRUNDHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "713-868-5861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2022; 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.