DERMATOLOGY AND SKIN CANCER CENTER OF WICHITA FALLS PLLC (NPI# 1164860599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164860599 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY AND SKIN CANCER CENTER OF WICHITA FALLS PLLC |
| Practice Address |
4327 Barnett Rd Wichita Falls TX 76310-2303 |
| Practice Telephone | 9406873376 |
| Practice Fax Number | 9406873377 |
| Mailing Telephone | 9406873376 |
| Mailing Fax Number | 9406873377 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | DANIEL L CHRISTIANSEN (SOLE OWNER/MEMBER) |
| Authorized Official Telephone | 9406873376 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4327 BARNETT RD |
| City | WICHITA FALLS |
| State | TX |
| Zip Code | 76310-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538169040 | Brian Cottrell Hull | Family Medicine | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2005-07-26 |
| 1346859378 | Amber Jackson | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2020-07-27 |
| 1144851486 | Mackenzie Larae Quigley | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2020-01-27 |
| 1437792223 | Blayne Berry | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2019-10-24 |
| 1699325050 | Tosha Renee Chesar | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2019-09-18 |
| 1609331354 | David Michael Ferguson | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2019-02-07 |
| 1508335217 | Julie Ann Borchardt | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2018-11-26 |
| 1598232886 | Darla Jan Bonner | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2018-10-25 |
| 1841766946 | Bobbie Jo Mckenzie | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2018-10-17 |
| 1699250274 | David Michael Mahler | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2018-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205329067 | Alesha Lynn Dean | Licensed Vocational Nurse | 6211 Talon Trail, Wichita Falls, TX 76310 | 2018-06-07 |
| 1962766741 | Kimberly D'anne Ravelo | Audiologist | 1 Burnside Drive, Wichita Falls, TX 76310 | 2012-06-27 |
| 1407142417 | Tobin Strom | Radiology | Texas Oncology, 5400 Kell West Blvd, Wichita Falls, TX 76310 | 2011-06-28 |
| 1386850055 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 6086 Kovarik Road, Wichita Falls, TX 76310 | 2007-05-16 |
| 1639391394 | Amy Louise Walmsley | Pharmacist | 1724 Woodridge Dr, Wichita Falls, TX 76310 | 2007-05-03 |
| 1619007416 | Stephanie Joy Postma | Specialist/Technologist | #1 West Medical Court, Wichita Falls, TX 76310 | 2007-03-07 |
| 1568518306 | Bestcare Health Services,inc | Home Health | 5800 Kell West Blvd, Suite 500, Wichita Falls, TX 76310 | 2007-01-26 |
| 1851453856 | Anthony Armando Denis Noya | Family Medicine | 8 Prairie Lace Court, Wichita Falls, TX 76310 | 2006-12-15 |
| 1629295621 | Kell Primary Care Pa | Family Medicine | 5500 Kell West Blvd, Suite 500, Wichita Falls, TX 76310 | 2007-04-19 |
| 1700900511 | Ralph Nmi Kauley Jr. | Physician Assistant | 5420 Kell West Blvd, Kell West Regional Hospital, Wichita Falls, TX 76310 | 2007-03-19 |
| Find all providers in zip 76310 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073055257 | Mamad Bagheri Md Pa | Dermatology | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2016-11-05 |
| 1467560201 | Mamad Mirza Bagheri | Dermatology | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649800848 | Skin Cancer Dermatology, Pllc | Dermatology | 3327 Research Plz Ste 414, San Antonio, TX 78235-5159 | 2020-01-16 |
| 1598302721 | Austin Skin Pllc | Dermatology | 1501 Dorothy Nichols Ln # B, Smithville, TX 78957-1725 | 2019-12-06 |
| 1154717726 | Joshua Lee Owen | Dermatology | 2632 Broadway, Suite 300 South, San Antonio, TX 78215-7821 | 2015-04-10 |
| 1043615263 | Epiphany Dermatology Pa | Dermatology | 7106 Sanger Avenue, Waco, TX 76712-3928 | 2014-10-30 |
| 1255745915 | Leon Chen | Dermatology | 6655 Travis St Ste 650, Houston, TX 77030-1316 | 2014-06-19 |
| 1750624391 | Houston Skin Cancer Associates, Pllc | Dermatology | 1401 Binz Street, Suite 200, Houston, TX 77004 | 2013-04-02 |
| 1457695413 | Oliver Street 5.01(a) Inc. | Dermatology | 5310 Harvest Hill Rd Ste 290, Dallas, TX 75230-5826 | 2012-11-15 |
| 1427330588 | Michael A. Sorace Md Pa | Dermatology | 7950 Floyd Curl Dr Ste 505, Medical Center Tower 1, San Antonio, TX 78229-3924 | 2011-09-15 |
| 1811229180 | Skin Surgery Center, Pa | Dermatology | 6208 Colleyville Blvd, Suite 100, Colleyville, TX 76034-6223 | 2010-02-11 |
| 1265614168 | Michael Sorace | Dermatology | 745 W San Antonio Ave, Suite 100, Boerne, TX 78006-3213 | 2007-12-03 |
| Find all providers with the same taxonomy | ||||
| City | WICHITA FALLS |
| Zip Code | 76310 |
Please comment or provide details below to improve the information on DERMATOLOGY AND SKIN CANCER CENTER OF WICHITA FALLS PLLC.
| 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.