Affilliated Dermatologists of Corpus Christi P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AFFILLIATED DERMATOLOGISTS OF CORPUS CHRISTI P.A.

Practice address

4521 S Staples St Ste 100
Corpus Christi, TX 78411-2603

Phone

(361) 993-9363

Fax

(361) 993-9366

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donald L. Iden, M.D.NPI 1013913318

Title

President

Phone

(361) 993-9363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald L Iden, M.D.

  • Specialist
  • Corpus Christi, TX
  • NPI 1013913318
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891828026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 S STAPLES ST STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112603",
            "telephone_number": "361-993-9363",
            "fax_number": "361-993-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 S STAPLES ST STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112603",
            "telephone_number": "361-993-9363",
            "fax_number": "361-993-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILLIATED DERMATOLOGISTS OF CORPUS CHRISTI P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IDEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-993-9363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "BS#K40V",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.