PALO DURO DERMATOLOGY, PLLC (NPI# 1699120048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699120048 |
| Entity Type | Organization |
| Organization Name | PALO DURO DERMATOLOGY, PLLC |
| Practice Address |
2005 N 2nd Ave Ste D Canyon TX 79015-2545 |
| Mailing Address |
Po Box 1638 Canyon TX 79015-1638 |
| Practice Telephone | 8065530185 |
| Practice Fax Number | 8068536630 |
| Mailing Telephone | 8064882176 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-10-02 |
| Authorized Official Name | LARRY C ROBERTS (OWNER) |
| Authorized Official Telephone | 8065530185 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CLIA | 45D2117683 | 01 |
| Street Address |
2005 N 2ND AVE STE D |
| City | CANYON |
| State | TX |
| Zip Code | 79015-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578565859 | Larry C Roberts | Specialist | 2005 N 2nd Ave Ste D, Canyon, TX 79015-2545 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194195826 | Melani Kelly | Specialist/Technologist | 702 3rd Avenue, Canyon, TX 79015 | 2015-10-07 |
| 1063846111 | Erin Ann Park | Physical Medicine & Rehabilitation | 907 23rd St., Canyon, TX 79015 | 2013-08-26 |
| 1003177197 | True Blessings LLC | Home Health | 1317 4th Avenue, Canyon, TX 79015 | 2012-06-05 |
| 1245460625 | Gloria Lewis | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015 | 2009-07-21 |
| 1376669861 | Assisted Living Concepts Inc | Assisted Living Facility | 2 Cottonwood Lane, Canyon, TX 79015 | 2007-03-22 |
| 1376568642 | D'aun Chrie Bowers | Emergency Medicine | 500 20th St, Canyon, TX 79015 | 2006-07-13 |
| 1760931497 | Kershen Health Services | Physical Therapist | 1613 4th Ave, Canyon, TX 79015 | 2016-09-22 |
| 1568730034 | Katherine Sheri Rogers | Physical Therapist | 15 Hospital Drive, Canyon, TX 79015 | 2011-12-12 |
| 1437273158 | Tommy W Brian I | Nurse Practitioner | 911 23rd St, Canyon, TX 79015 | 2007-03-19 |
| 1194377754 | Emily Collins | Occupational Therapist | 18 Case Ln, Canyon, TX 79015-1796 | 2019-07-14 |
| Find all providers in zip 79015 | ||||
| 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 |
|---|---|---|---|---|
| 1265030456 | Andrew M. Quinn IIi, Md Pllc | Dermatology | 4110 Bellaire Blvd Ste 202, Houston, TX 77025-1057 | 2020-10-11 |
| 1639786999 | Carolyn Huyen Trieu | Dermatology | 7700 San Felipe St Ste 492, Houston, TX 77063-1630 | 2020-09-29 |
| 1366057861 | Young E Martin | Dermatology | 910 W Parker Rd Ste 210, Plano, TX 75075-2361 | 2020-09-11 |
| 1700498136 | Optimal Health and Skin LLC | Dermatology | 4701 Old Shepard Pl Ste 260, Plano, TX 75093-5250 | 2020-08-18 |
| 1962023077 | Bluebonnet Dermatology, Pllc | Dermatology | 935 W Exchange Parkway, Building B, Suite 130, Allen, TX 75013-7075 | 2020-04-29 |
| 1205461019 | Affinity Dermatology Pllc | Dermatology | 13052 Dallas Parkway Suite 520, Frisco, TX 75033 | 2020-03-12 |
| 1518506054 | Duong Thuy Nguyen | Dermatology | 1134 Globe St, Houston, TX 77034-1109 | 2020-01-01 |
| 1558904953 | Lorin Brittney Anderson | Dermatology | 5928 Chisholm Trl, Mckinney, TX 75070-6464 | 2019-10-18 |
| 1912549833 | Prestige Dermatology of Midlothian | Dermatology | 320 Hawkins Run Rd., Suite 1, Midlothian, TX 76065 | 2019-10-11 |
| 1891346359 | Westlake Dermatology of San Antonio Pllc | Dermatology | 5500 Broadway Ave Ste R100, Alamo Heights, TX 78209 | 2019-09-26 |
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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.