Organization
DERMATOLOGY SPECIALISTS OF SAN ANTONIO, PLLC
Active
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up