Baytown Dermatology, P.a.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D0496518CLIA Issued in TX

Legal business name

BAYTOWN DERMATOLOGY, P.A.

Practice address

3730 Emmett Hutto Blvd
Baytown, TX 77521-1764

Phone

(281) 425-9375

Fax

(281) 427-4584

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Conner Chan, MDNPI 1962669515

Title

Ceo

Phone

(281) 425-9375

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Baytown Dermatopathology Laboratory Doing business as

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 3

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

• Conner Chan, MD

  • Dermatology Physician
  • Baytown, TX
  • NPI 1962669515
  NPD Authorized official
• Ramon Larrea Sanchez, M.D.

  • Dermatology Physician
  • Galveston, TX
  • NPI 1366556193
  NPD
• Ashley Rae Group, MD

  • Dermatology Physician
  • Keene, NH
  • NPI 1558528406
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1962599217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYTOWN DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CONNER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-425-9375",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0496518CLIA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690008222",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "CL8288",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0496518",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baytown Dermatopathology Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baytown Dermatopathology Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Baytown ASC, LP
• Baytown Cardiology and Associates
• Baytown Dental Care, PLLC
• Baytown Dental Group
• Baytown Dermatology, P.a.
• Baytown Emergency Center, LLC
• Baytown Emergency Physician Group, PLLC
• Baytown Endoscopy Center, LLC
• Baytown Eye Care
• Baytown Family Practice PA

• Clinical Medical Laboratory in Baytown, TX
• Providers in Baytown, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.