Organization
DALLAS DERMATOLOGY
Active
Other names
Paris Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE WALDING (BILLING MANAGER)
(972) 563-8500
Entity
Organization
Contact information
Practice address
3110 LAMAR AVE, PARIS, TX 75460-5020
(903) 204-4244
(903) 905-4994
Mailing address
763 E US HIGHWAY 80, STE. 200, FORNEY, TX 75126-8633
(972) 563-8500
(972) 563-8501
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
K8565
TX
207NS0135X
Procedural Dermatology Physician
K8565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00113Y
MEDICARE PTAN
TX
Enumeration date
03/27/2014
Last updated
03/27/2014
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