Dermatology Surgery Center
LBN: Oliver Street Dermatology Asc Llc
Dermatology Surgery Center is an health care organization with primary practice located at 1367 Dominion Plaza , Tyler TX 75703-1013. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty.
Oliver Street Dermatology Asc Llc can be contacted via phone (903) 534-6200, or through Stein, Andrea Lynne via phone (903) 534-6200.
Contact Information
Primary practice address
1367 Dominion Plaza
Tyler TX 75703-1013
Phone: (903) 534-6200
Fax: (903) 939-0755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 007937 | Texas |
Profile Details
| NPI number | 1700822335 |
|---|---|
| LBN Legal business name | Oliver Street Dermatology Asc Llc |
| DBA Doing business as | Dermatology Surgery Center |
| Authorized official | Stein, Andrea Lynne Registered Nurse (RN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Feb 6th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700822335 | NPPES |
| Texas | Other | P00044713 | RAILROAD MEDICARE PTAN |
| Texas | MEDICAID | 162384501 | RAILROAD MEDICARE PTAN |
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