Organization
DERMATOLOGY PLACE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUDLEY WINSLOW GOETZ DO (PHYSICIAN OWNER)
(817) 261-9665
Entity
Organization
Contact information
Practice address
1000 W RANDOL MILL ROAD, ARLINGTON, TX 76012-2512
(817) 261-9665
(817) 795-5750
Mailing address
1000 W RANDOL MILL ROAD, ARLINGTON, TX 76012-2512
(817) 261-9665
(817) 795-5750
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G1907
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00H55N
GROUP ID NUMBER
—
Enumeration date
12/04/2007
Last updated
07/15/2010
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