Organization
ADVANCED DERMATOLOGY AND SKIN CARE PA
Active
Organization
ADVANCED DERMATOLOGY AND SKIN CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DUNCAN M.D. (PRACTICE OWNER)
(281) 392-3803
Entity
Organization
Contact information
Practice address
430 S MASON RD, SUITE 101, KATY, TX 77450-2447
(281) 392-3803
(281) 392-6766
Mailing address
PO BOX 710270, HOUSTON, TX 77271-0270
(281) 392-3803
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042KK
BCBS
—
01
—
45D1019065
CLIA NUMBER
—
01
—
45D2052501
CLIA
TX
01
—
DA6818
RR MEDICARE GRP HARRIS CO
—
01
—
DD9883
RR MEDICARE GRP BRAZORIA
—
Enumeration date
07/04/2006
Last updated
04/19/2016
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