Prestige Dermatology of Midlothian

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PRESTIGE DERMATOLOGY OF MIDLOTHIAN

Practice address

320 Hawkins Run Rd.
Suite 1
Midlothian, TX 76065

Phone

(469) 758-4800

NPI assigned

Oct 11, 2019

Organization subpart

No

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

Authorized official

Name

Ryan PhamNPI 1407173230

Title

Managing Member

Phone

(817) 718-3571

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

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

• Ryan Pham, D.O

  • Dermatology Physician
  • Burleson, TX
  • NPI 1407173230
  Medicare reassignment Care Compare group NPD Authorized official
• Nhi Le, D.O.

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1043670409
  Medicare reassignment Care Compare group NPD
• Nguyet Anh Nguyen, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Midlothian, TX
  • NPI 1083143093
  Medicare reassignment Care Compare group
• Hong DO, FNP-BC

  • Nurse Practitioner
  • Burleson, TX
  • NPI 1639683576
  Medicare reassignment NPD
• Tram Ho, MPAS, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1093146805
  Medicare reassignment

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1912549833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HAWKINS RUN RD",
            "address_2": "SUITE 1",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "76065",
            "telephone_number": "469-758-4800",
            "fax_number": "972-775-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 HAWKINS RUN RD.",
            "address_2": "SUITE 1",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "76065",
            "telephone_number": "469-758-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DERMATOLOGY OF MIDLOTHIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-718-3571"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rae Place, OTR, OTD
• Paige Andrea Pollard, OD
• Precision Chiro Clinics LLC
• Pressley Pediatrics
• Cynthia Ann Pressley, R.N. C.P.N.P.
• Megan Elizabeth Proudfoot, RN
• Prudential Medical Network, LP
• Alison Renee Pugh, LCSW
• Melissa Pulido
• Patricia S Quinn, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.