Organization
WARTHAN DERMATOLOGY DALLAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN HILL (PRACTICE MANAGER)
(817) 923-8220
Entity
Organization
Contact information
Practice address
12222 COIT RD STE 200, DALLAS, TX 75251-2302
(817) 923-8220
Mailing address
5751 EDWARDS RANCH RD STE 101, FORT WORTH, TX 76109-4131
(817) 923-8220
(817) 923-9004
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073773867
NPI
TX
01
—
1740712363
NPI
TX
Enumeration date
08/16/2023
Last updated
08/16/2023
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