Organization
SUMMIT DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON L BLASER MD (PRESIDENT)
(903) 593-9474
Entity
Organization
Contact information
Practice address
1038 S FLEISHEL AVE, TYLER, TX 75701-2044
(903) 593-9474
(903) 593-9477
Mailing address
1038 S FLEISHEL AVE, TYLER, TX 75701-2044
(903) 593-9474
(903) 593-9477
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
K9734
TX
207ND0900X
Dermatopathology Physician
K9734
TX
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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