Organization
SKIN SURGERY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEGO E. MARRA M.D. (DIRECTOR)
(817) 924-5200
Entity
Organization
Contact information
Practice address
6208 COLLEYVILLE BLVD, SUITE 100, COLLEYVILLE, TX 76034-6223
(817) 924-5200
(817) 924-5266
Mailing address
3000 S HULEN ST, SUITE 124-228, FORT WORTH, TX 76109-1929
(817) 924-5200
(817) 924-5266
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
M5353
TX
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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