Organization
ABILENE DERMATOLOGY AND SKIN SURGERY CENTER PC
Active
Organization
ABILENE DERMATOLOGY AND SKIN SURGERY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SINA ABOUTALEBI MD (VICE PRESIDENT)
(325) 672-5603
Entity
Organization
Contact information
Practice address
3190 ANTILLEY RD, ABILENE, TX 79606-5006
(325) 672-5603
(325) 672-6570
Mailing address
3190 ANTILLEY ROAD, ABILENE, TX 79606-5015
(325) 672-5603
(325) 672-6570
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087QH
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
CG5724
RAILROAD MEDICARE
TX
Enumeration date
11/02/2007
Last updated
11/15/2023
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