Organization
DERMATOLOGY SPECIALISTS OF SAN ANTONIO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE MARIE OWENS MD (MANAGING OWNER)
(210) 541-4884
Entity
Organization
Contact information
Practice address
2520 BROADWAY ST STE 202, SAN ANTONIO, TX 78215-1149
(210) 541-4884
(210) 541-4900
Mailing address
4919 MEMORIAL HWY STE 150, TAMPA, FL 33634-7516
(813) 333-1512
(813) 333-1561
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H000R0R101
BCBSTX
TX
Enumeration date
02/19/2015
Last updated
04/19/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us