Organization
WESTLAKE DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY NIKOLAIDIS MD (OWNER/PRESIDENT)
(512) 328-3376
Entity
Organization
Contact information
Practice address
401 RR 620 N, SUITE 200, LAKEWAY, TX 78734-3910
(512) 610-0549
(512) 306-0222
Mailing address
6836 BEE CAVES RD, SUITE 111, AUSTIN, TX 78746-5059
(512) 328-3376
(512) 306-0222
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
TX
207N00000X
Dermatology Physician
Primary
—
TX
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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