Organization
AIRPORT DERMATOLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRIS ROTMAN M.D. (PRESIDENT)
(281) 484-7546
Entity
Organization
Contact information
Practice address
11914 ASTORIA BLVD, SUITE 340, HOUSTON, TX 77089-6064
(281) 484-7546
(281) 484-2202
Mailing address
11914 ASTORIA BLVD, SUITE 340, HOUSTON, TX 77089-6064
(281) 484-7546
(281) 484-2202
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
D-5828
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0340473-01
—
TX
01
—
071445445
RAILROAD MEDICARE
TX
Enumeration date
08/06/2008
Last updated
08/06/2008
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