LONE STAR STATE DERMATOLOGY CLINIC PLLC (NPI# 1053723239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053723239 |
| Entity Type | Organization |
| Organization Name | LONE STAR STATE DERMATOLOGY CLINIC PLLC |
| Practice Address |
11485 Toepperwein Rd Suite 2 Live Oak TX 78233-3143 |
| Practice Telephone | 2106513233 |
| Practice Fax Number | 2106513234 |
| Mailing Telephone | 2106513233 |
| Mailing Fax Number | 2106513234 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2015-11-17 |
| Authorized Official Name | MRS. MICHELLE NICOLE REYES (OFFICE MANAGER) |
| Authorized Official Telephone | 2106513233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
K8022 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
11485 TOEPPERWEIN RD SUITE 2 |
| City | LIVE OAK |
| State | TX |
| Zip Code | 78233-3143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205827532 | Jean-denis Boucher | Dermatology | 11485 Toepperwein Rd, Suite 2, Live Oak, TX 78233-3143 | 2005-11-04 |
| 1386826634 | David Ochoa, M.d.,p.a. | Clinic/Center | 11485 Toepperwein Rd, Ste. 1, Live Oak, TX 78233-3143 | 2007-11-28 |
| 1922059385 | David A. Ochoa | Family Medicine | 11485 Toepperwein Rd, Ste 1, Live Oak, TX 78233-3143 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162451 | Jennifer Chaghoury | Chore Provider | 4606 La Marquesa St, San Antonio, TX 78233 | 2020-07-27 |
| 1912515719 | Creative Health Care Management, LLC | Physical Therapist | 4415 Rio D'oro St, San Antonio, TX 78233 | 2020-07-17 |
| 1841822749 | Edilma Yosmara Medrano | Nurse's Aide | 209 Goforth Drive, San Antonio, TX 78233 | 2020-02-07 |
| 1578194411 | Jorge Javier Jaramillo De La Torre | Neurological Surgery | Cuauhtemoc 380, Col. Moderna, San Luis Potosi, SLP 78233 | 2020-01-29 |
| 1174182000 | Shenila Rajani Od Pllc | Optometrist | 12349 I-35, San Antonio, TX 78233 | 2019-06-13 |
| 1659935609 | Mff Amber Oaks LLC | Assisted Living Facility | 4415 Rio Doro St., San Antonio, TX 78233 | 2019-04-25 |
| 1457862302 | Antoinette Marie Powell | Massage Therapist | 14615 Interstate 35 N, Live Oak, TX 78233 | 2017-10-18 |
| 1154852150 | Dustin William Koenning | Pharmacist | 6019 Randolph Blvd., San Antonio, TX 78233 | 2017-03-22 |
| 1316481153 | U S Anesthesia Partners of Texas, Pa | Physician Assistant | 12602 Toepperwein Rd Ste 218, Live Oak, TX 78233 | 2016-12-13 |
| 1477096121 | Vanessa's Garden of Hope Assisted Living,llc | Assisted Living Facility | 4350 Shallow Water, San Antonio, TX 78233 | 2016-11-29 |
| Find all providers in zip 78233 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205827532 | Jean-denis Boucher | Dermatology | 11485 Toepperwein Rd, Suite 2, Live Oak, TX 78233-3143 | 2005-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011229 | A Healthier You LLC | Dermatology | 5722 Forest Bend Dr Ste 110, Arlington, TX 76017-1143 | 2020-10-20 |
| 1548777683 | Khidja Seymour | Dermatology | 5288 Trail Lake Dr Ste 13, Fort Worth, TX 76133-1939 | 2018-01-10 |
| 1124484456 | Texas Surgical Dermatology Pa | Dermatology | 21009 Kuykendahl, Suite A, Spring, TX 77379-0000 | 2015-12-31 |
| 1306263256 | Dallas Dermatology | Dermatology | 3110 Lamar Ave, Paris, TX 75460-5020 | 2014-03-27 |
| 1437461258 | Brundha Balaraman | Dermatology | 4747 Bellaire Blvd Ste 240, Bellaire, TX 77401 | 2010-07-09 |
| 1477726214 | Liet N Le | Dermatology | 22659 Highway 59 N, Ste 140, Kingwood, TX 77339-4406 | 2008-04-11 |
| 1821266743 | Linda C Barrows M.d., P.a. | Dermatology | 6800 West Loop S Ste 525, Bellaire, TX 77401-4529 | 2008-02-13 |
| 1053505701 | Kris L Howard Md Pa | Dermatology | 8141 Dorado Dr, Odessa, TX 79765-8533 | 2007-09-05 |
| 1700990736 | Steven Eric Zimmet | Dermatology | 1500 W 34th St, Austin, TX 78703-1433 | 2006-08-18 |
| 1427080076 | Michael G Lehman Iv | Dermatology | 3517 21st Street, Lubbock, TX 79410 | 2006-07-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.