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Organization

ALL SKIN DERMATOLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GRACE AYANDIBU MD, MS (MEDICAL DIRECTOR)
(940) 239-9160
Entity
Organization

Contact information

Practice address
2637 PLAZA PKWY, WICHITA FALLS, TX 76308-3889
(940) 239-9160
Mailing address
2637 PLAZA PKWY, WICHITA FALLS, TX 76308-3889
(940) 239-9160

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician
Primary

Other

Enumeration date
12/14/2022
Last updated
04/10/2023
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