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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