Dermatology Southwest

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

H9018 Issued in TX

Legal business name

DERMATOLOGY SOUTHWEST

Practice address

12001 South Fwy
Ste. 205
Burleson, TX 76028-7208

Phone

(817) 568-0500

Fax

(817) 568-0501

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed Basem Chaker, MD

Title

President

Phone

(817) 568-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• M. Basem Chaker, MD, PA Former legal business name

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1972832731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 SOUTH FWY",
            "address_2": "STE. 205",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287208",
            "telephone_number": "817-568-0500",
            "fax_number": "817-568-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 SOUTH FWY",
            "address_2": "STE. 205",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287208",
            "telephone_number": "817-568-0500",
            "fax_number": "817-568-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SOUTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "CHAKER",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "BASEM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-568-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "H9018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "00532R",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M. Basem Chaker, MD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• DFW Senior Care Servies
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• Bimala Dhakal, APRN, AGACNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.