CRYSTAL POURCIAU (NPI# 1225230915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225230915 |
Entity Type | Individual |
Full Name | CRYSTAL POURCIAU |
Credential | M.D. |
Practice Address |
51 N Dunlap St Fl 4 Memphis TN 38105-4625 |
Mailing Address |
49 N Dunlap St Fl 3 Memphis TN 38103-2802 |
Practice Telephone | 9012877337 |
Practice Fax Number | 9012875506 |
Mailing Telephone | 9012874825 |
Mailing Fax Number | 9012874820 |
Enumeration Date | 2007-06-04 |
Last Update Date | 2018-03-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
56555 | TN | Allopathic & Osteopathic Physicians |
N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
N9400 | TX | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
6701 Fannin St, Suite 670, Houston, TX 770302608 | 8328223720 |
Street Address |
51 N DUNLAP ST FL 4 |
City | MEMPHIS |
State | TN |
Zip Code | 38105-4625 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306360680 | Shannon Holtrop | Genetic Counselor, MS | 51 N Dunlap St Fl 4, Memphis, TN 38105-4625 | 2017-07-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447887435 | Leeanne Chittom Mcdonald | Dietitian, Registered | Ulps Surgery, 2nd Floor, 50 N. Dunlap, Memphis, TN 38105 | 2020-03-27 |
1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
1720436710 | Angela Marie Pratt | Nurse Practitioner | 262 Danny Thomas Blvd, Memphis, TN 38105 | 2016-05-31 |
1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
1467864173 | Nicole Mary Alberts | Psychologist | 262 Danny Thomas Place, Mail Stop 740, Department of Psychology, St Jude Children's Research H, Memphis, TN 38105 | 2014-05-29 |
1689004160 | Virginia Carney | Dietitian, Registered | 262 Danny Thomas Place - Mail Stop 732, Memphis, TN 38105 | 2013-11-19 |
1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
1457622235 | Healthy Indigent Populations Inc. | Exclusive Provider Organization | 1066 Delmar, Memphis, TN 38105 | 2012-01-25 |
1285953265 | Nicholas Steve Phillips | Student in an Organized Health Care Education/Training Program | 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105 | 2010-05-31 |
1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
Find all providers in zip 38105 |
Taxonomy Code | 207NP0225X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | Pediatric Dermatology |
A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: changed definition, added source] Additional Resources: American Board of Dermatology, 2007, http://www.abderm.org/ A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093024101 | Ut Lebonheur Pediatric Specialists, Inc. | Dermatology | 848 Adams Ave., Memphis, TN 38103 | 2010-10-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114074093 | Christopher Robb | Dermatology | 1229 Reserve Blvd, Suite 200, Spring Hill, TN 37174 | 2007-01-04 |
1003963976 | Benjamin Hayes | Dermatology | 3098 Campbell Station Pkwy Ste A201, Spring Hill, TN 37174-4405 | 2007-01-04 |
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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.