Organization
HIGHLAND DERMATOLOGY AND PLASTIC SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN J TITTLE MD (OWNER)
(214) 905-5075
Entity
Organization
Contact information
Practice address
3607 OAK LAWN AVE, SUITE 200, DALLAS, TX 75219-4311
(214) 905-5075
(214) 905-0903
Mailing address
10743 PRESTON RD, DALLAS, TX 75230-3806
(214) 905-5075
(214) 905-0903
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
F7235
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699851923
NPI
TX
Enumeration date
10/27/2014
Last updated
10/27/2014
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