DR. BLAKELY S RICHARDSON (NPI# 1659697431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659697431 |
| Entity Type | Individual |
| Full Name | DR. BLAKELY S RICHARDSON |
| Credential | D.O. |
| Practice Address |
2559 Western Trails Blvd Suite 301 Austin TX 78745-1565 |
| Mailing Address |
2559 Western Trails Blvd Ste 301 Austin TX 78745-1565 |
| Practice Telephone | 5128152559 |
| Mailing Telephone | 5128152559 |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2016-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | P7024 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS STATE LICENSE | P7024 | 01 |
| Street Address |
2559 WESTERN TRAILS BLVD SUITE 301 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78745-1565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962592071 | Stanley Suchy Wang | Internal Medicine | 2559 Western Trails Blvd, Suite 100, Austin, TX 78745-1565 | 2006-10-13 |
| 1770901589 | Westgate Skin & Cancer, Pllc | Dermatology | 2559 Western Trails Blvd, Suite 301, Austin, TX 78745-1565 | 2014-03-31 |
| 1528311297 | Heidi A Bollock | Clinical Nurse Specialist | 2559 Western Trails Blvd, Ste. 200, Austin, TX 78745-1565 | 2012-10-18 |
| 1124331665 | Molly Kristen Cahill-kert | Nurse Practitioner | 2559 Western Trails Blvd, Suite 200, Austin, TX 78745-1554 | 2010-07-26 |
| 1619201134 | Karen Hejtmancik Blakley | Clinical Nurse Specialist | 2559 Western Trails Blvd, Suite 200, Austin, TX 78745-1554 | 2009-09-30 |
| 1003027699 | Staci R Ianiro | Dentist | 2559 Western Trails Blvd, Suite 302, Austin, TX 78745-1565 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617511 | Samantha Lynne Weston | Speech-Language Pathologist | 8515 Brodie Lane, Apt 2011, Austin, TX 78745 | 2020-10-26 |
| 1275172686 | Nithphaphone Tracy Bounsing | Registered Nurse | 4316 James Casey St, Building F, Suite 201, Austin, TX 78745 | 2020-01-02 |
| 1225685712 | Integrative Medical Group of Texas | General Practice | 6905 West Gate Blvd. Ste A, Austin, TX 78745 | 2019-08-20 |
| 1962971499 | Kimberly Angela Mancini | Social Worker | 5015 South Ih 35 Frontage Road, Austin, TX 78745 | 2018-11-14 |
| 1093223885 | Emma Rose Marek | Speech-Language Pathologist | 2700 Norfolk Drive, Austin, TX 78745 | 2018-01-16 |
| 1528586690 | Ashley Ellison | Social Worker | 4201 South Congress, Austin, TX 78745 | 2017-09-08 |
| 1134666761 | Carey Sebera | Counselor | 2812 Goldbridge Dr, Austin, TX 78745 | 2017-01-20 |
| 1932644507 | Maya Conlon | Social Worker | 2501 W. William Cannon Dr., Bldg 6 Ste. A, Austin, TX 78745 | 2017-01-05 |
| 1285189134 | 512 Physical Therapy and Golf Performance Center | Physical Therapist | 6800 Westgate Blvd, Suite 117, Austin, TX 78745 | 2016-08-22 |
| 1326401803 | Chris Winkley | Physical Therapist | 5510 S Ih 35 Frontage Rd #240, Austin, TX 78745 | 2016-04-01 |
| Find all providers in zip 78745 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962864488 | Mark Correa | Dermatology | 4419 Frontier Trl Ste 110, Austin, TX 78745-1567 | 2016-03-23 |
| 1699166991 | Elizabeth L Foley | Dermatology | 505 W Louis Henna Blvd Ste 200, Austin, TX 78728-1703 | 2015-02-09 |
| 1225461924 | Nicholas R Snavely Md | Dermatology | 10815 Rr 2222 Bldg 3a Ste 200, Austin, TX 78730-1159 | 2013-08-16 |
| 1730521113 | James William Green | Dermatology | 9108 Zyle Rd, Austin, TX 78737 | 2013-07-25 |
| 1568808459 | On Site Dermatology of Texas Pllc | Dermatology | 6500 River Place Blvd, Suite 250, Building 7, Austin, TX 78730-1119 | 2013-05-17 |
| 1699044800 | Balcones Dermatology Associates, P.a. | Dermatology | 8240 N. Mo Pac Expwy, Ste 350, Austin, TX 78759 | 2011-12-16 |
| 1689957169 | Sanova Dermatology Pllc | Dermatology | 12319 N Mopac Expy Ste 100, Austin, TX 78758-2486 | 2011-09-21 |
| 1740573997 | Olubusayo Obayan | Dermatology | 3303 Northland Dr Ste 308, Austin, TX 78731 | 2011-05-20 |
| 1306166152 | Elizabeth Rebecca Geddes-bruce | Dermatology | 3637 Far West Blvd Ste E, Austin, TX 78731-4126 | 2010-06-03 |
| 1033437835 | Stanley Tyler Hollmig | Dermatology | 1601 Trinity St Ste 704b, Austin, TX 78712 | 2010-05-04 |
| Find all providers in AUSTIN | ||||
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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.