Organization
BROWNWOOD DERMATOLOGY PLLC
Active
Other names
Epiphany Dermatology PA
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (ADMINISTRATOR)
(512) 960-5760
Entity
Organization
Contact information
Practice address
2504 CROCKETT DR, BROWNWOOD, TX 76801-5900
(325) 646-2929
(325) 641-0122
Mailing address
6601 VAUGHT RANCH RD STE 200, AUSTIN, TX 78730-2309
(512) 628-0465
(512) 628-0468
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
Q1815
TX
Other
Enumeration date
06/17/2015
Last updated
09/23/2016
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