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Organization

DERMATOLOGY & COSMETIC SURGERY ASSOCIATES PA

Active
Other names
Lifeway Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTHONY PHAN NIKKO MD (PRESIDENT)
(713) 960-1311
Entity
Organization

Contact information

Practice address
1001 WEST LOOP S, STE 813, HOUSTON, TX 77027-9084
(713) 960-1311
(713) 960-1325
Mailing address
1001 WEST LOOP S, STE 813, HOUSTON, TX 77027-9084
(713) 960-1311
(713) 960-1325

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K5639
TX

Other

Enumeration date
10/03/2013
Last updated
10/03/2013
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